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Treatment of Caliceal Diverticula

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Advanced Endourology

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Caliceal diverticula represent a therapeutic challenge for the endourologist. Treatment options for symptomatic, stone-bearing, caliceal diverticula include shockwave lithotripsy (SWL), ureteroscopy, percutaneous nephrostolithotomy/ablation, and laparoscopic unroofing. A surprising number of patients achieve symptomatic relief despite poor stone-free rates with SWL, although this approach is best reserved for patients with a small stone burden in a diverticulum with a widely patent neck. Ureteroscopic management (consisting of laser endoinfundibulotomy or balloon dilation of the infundibular neck and fragmentation/removal of the stones) is a good option for relatively small, upper or middle caliceal diverticula with stones less than 15 mm in size. The percutaneous approach is associated with the highest stone-, symptom-, and diverticulum-free rates and is the optimal treatment for all but anteriorly located diverticula. Lastly, laparoscopy is reserved for large, anteriorly positioned diverticula or diverticula that fail endourological management.

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References

  1. Wulfsohn MA. Pyelocaliceal diverticula. J Urol 1980; 123: 1–8.

    PubMed  CAS  Google Scholar 

  2. Middleton AW Jr., Pfister RC. Stone-containing pyelocaliceal diverticulum: embryogenic, anatomic, radiologic and clinical characteristics. J Urol 1974; 111: 2–6.

    PubMed  Google Scholar 

  3. Timmons JW Jr., Malek RS, Hattery RR, Deweerd JH. Caliceal diverticulum. J Urol 1975; 114: 6–9.

    PubMed  Google Scholar 

  4. Williams G, Blandy JP, Tresidder GC. Communicating cysts and diverticula of the renal pelvis. Br J Urol 1969; 41: 163–170.

    PubMed  CAS  Google Scholar 

  5. Yow RM, Bunts RC. Calyceal diverticulum. J Urol 1955; 73: 663–670.

    PubMed  CAS  Google Scholar 

  6. Devine CJ Jr., Guzman JA, Devine PC, Poutasse EF. Calyceal diverticulum. J Urol 1969; 101: 8–11.

    PubMed  Google Scholar 

  7. Chong TW, Bui MH, Fuchs GJ. Calyceal diverticula. Ureteroscopic management. Urol Clin North Am 2000; 27: 647–654.

    Article  PubMed  CAS  Google Scholar 

  8. Fuchs GJ, David RD. Flexible ureterorenoscopy, dilatation of narrow caliceal neck and ESWL: Anew minimally invasive approach to stones in caliceal diverticulua. J Endourol 1989; 3: 255–263.

    Google Scholar 

  9. Bennett JD, Brown TC, Kozak RI, Sales J, Denstedt JD. Transdiverticular percutaneous nephrostomy for caliceal diverticular stenosis. J Urol 1992; 6: 55–57.

    Google Scholar 

  10. Auge BK, Munver R, Kourambas J, Newman GE, Wu NZ, Preminger GM. Neoinfundibulotomy for the management of symptomatic caliceal diverticula. J Urol 2002; 167: 1616–1620.

    Article  PubMed  Google Scholar 

  11. Al-Basam S, Bennett JD, Layton ZA, Denstedt JD, Razvi H. Treatment of caliceal diverticular stones: transdiverticular percutaneous nephrolithotomy with creation of a neoinfundibulum. J Vasc Interv Radiol 2000; 11: 885–889.

    Article  PubMed  CAS  Google Scholar 

  12. Hulbert JC, Reddy PK, Hunter DW, Castaneda-Zuniga W, Amplatz K, Lange PH. Percutaneous techniques for the management of caliceal diverticula containing calculi. J Urol 1986; 135: 225–227.

    PubMed  CAS  Google Scholar 

  13. Eshghi M, Tuong W, Fernandez F, Addonizio JC. Percutaneous (Endo) Infundibulotomy. J Endourol 1987; 1:(2) 107–113.

    Google Scholar 

  14. Wilbert DM, Jenny E, Stoeckle M, Ridemiller H, Jacobi G. Calyceal diverticar stones: is ESWL worthwhile? J Urol 1986; 135: 183A

    Google Scholar 

  15. Psihramis KE, Dretler SP. Extracorporeal shock wave lithotripsy of caliceal diverticula calculi. J Urol 1987; 138: 707–711.

    PubMed  CAS  Google Scholar 

  16. Ritchie AW, Parr NJ, Moussa SA, Tolley DA. Lithotripsy for calculi in caliceal diverticula? PtuBr J Urol 1990; 66: 6–8.

    CAS  Google Scholar 

  17. Jones JA, Lingeman JE, Steidle CP. The roles of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy in the management of pyelocaliceal diverticula. J Urol 1991; 146: 724–727.

    PubMed  CAS  Google Scholar 

  18. Hendrikx AJ, Bierkens AF, Bos R, Oosterhof GO, Debruyne FM. Treatment of stones in caliceal diverticula: extracorporeal shock wave lithotripsy versus percutaneous nephrolitholapaxy. Br J Urol 1992; 70: 478–482.

    PubMed  CAS  Google Scholar 

  19. Streem SB, Yost A. Treatment of caliceal diverticular calculi with extracorporeal shock wave lithotripsy: patient selection and extended followup. J Urol 1992; 148: 1043–1046.

    PubMed  CAS  Google Scholar 

  20. Pang K, David RD, Fuchs GJ. Treatment of stones in caliceal diverticuli using retrograde endoscopic approach: Critical assessment after 2 years. J Endourol 1992; 6 (suppl): S80.

    Google Scholar 

  21. Grasso M, Lang G, Loisides P, Bagley D, Taylor F. Endoscopic management of the symptomatic caliceal diverticular calculus. J Urol 1995; 153: 1878–1881.

    Article  PubMed  CAS  Google Scholar 

  22. Batter SJ, Dretler SP. Ureterorenoscopic approach to the symptomatic caliceal diverticulum. J Urol 1997; 158: 709–713.

    Article  PubMed  CAS  Google Scholar 

  23. Chong TW, Bui MH, Fuchs GJ. Calyceal diverticula. Ureteroscopic management. Urol Clin North Am 2000; 27: 647–654.

    Article  PubMed  CAS  Google Scholar 

  24. Auge BK, Munver R, Kourambas J, Newman GE, Preminger GM. Endoscopic management of symptomatic caliceal diverticula: a retrospective comparison of percutaneous nephrolithotripsy and ureteroscopy. J Endourol 2002; 16: 557–563.

    Article  PubMed  Google Scholar 

  25. Hulbert JC, Hernandez-Graulau JM, Hunter DW, Castaneda-Zuniga W. Current concepts in the management of pyelocaliceal diverticula. J Endourol 1988; 2: 11–17.

    Google Scholar 

  26. Hedelin H, Geterud K, Grenabo L, Henriksson C, Pettersson S, Zachrisson BF. Percutaneous surgery for stones in pyelocaliceal diverticula. Br J Urol 1988; 62: 206–208.

    PubMed  CAS  Google Scholar 

  27. Ellis JH, Patterson SK, Sonda LP, Platt JF, Sheffner SE, Woolsey EJ. Stones and infection in renal caliceal diverticula: treatment with percutaneous procedures. AJR Am J Roentgenol 1991; 156: 995–1000.

    PubMed  CAS  Google Scholar 

  28. Shalhav AL, Soble JJ, Nakada SY, Wolf JS Jr, McClennan BL, Clayman RV. Long-term outcome of caliceal diverticula following percutaneous endosurgical management. J Urol 1998; 160: 1635–1639.

    Article  PubMed  CAS  Google Scholar 

  29. Ruckle HC, Segura JW. Laparoscopic treatment of a stone-filled, caliceal diverticulum: a definitive, minimally invasive therapeutic option. J Urol 1994; 151: 122–124.

    PubMed  CAS  Google Scholar 

  30. Hoznek A, Herard A, Ogiez N, Amsellem D, Chopin DK, Abbou CC. Symptomatic caliceal diverticula treated with extraperitoneal laparoscopic marsupialization fulguration and gelatin resorcinol formaldehyde glue obliteration. J Urol 1998; 160: 352–355.

    Article  PubMed  CAS  Google Scholar 

  31. Harewood LM, Agarwal D, Lindsay S, Vaughan MG, Cleeve LK, Webb DR. Extraperitoneal laparoscopic caliceal diverticulectomy. J Endourol 1996; 10: 425–430.

    Article  PubMed  CAS  Google Scholar 

  32. Curran MJ, Little AF, Bouyounes B, Nieh PT, Bihrle W 3rd. Retroperitoneoscopic technique for treating symptomatic caliceal diverticula. J Endourol 1999; 13: 723–725.

    Article  PubMed  CAS  Google Scholar 

  33. Miller SD, Ng CS, Streem SB, Gill IS. Laparoscopic management of caliceal diverticular calculi. J Urol 2002; 167: 1248–1252.

    Article  PubMed  Google Scholar 

  34. Lang EK. Percutaneous infundibuloplasty: management of calyceal diverticula and infundibular stenosis. Radiology 1991; 181: 871–877.

    PubMed  CAS  Google Scholar 

  35. Bellman GC, Silverstein JI, Blickensderfer S, Smith AD. Technique and follow-up of percutaneous management of caliceal diverticula. Urology 1993; 42: 21–25.

    Article  PubMed  CAS  Google Scholar 

  36. Donnellan SM, Harewood LM, Webb DR. Percutaneous management of caliceal diverticular calculi: technique and outcome. J Endourol 1999; 13: 83–88.

    PubMed  CAS  Google Scholar 

  37. Monga M, Smith R, Ferral H, Thomas R. Percutaneous ablation of caliceal diverticulum: long-term followup. J Urol 2000; 163: 28–32.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Urology, Department of Surgery, St. Joseph’s Hospital, McMaster University, Hamilton, ON, Canada

    Edward D. Matsumoto MD, FRCSC

  2. Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX

    Margaret S. Pearle MD, PhD, EARLE

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  1. Edward D. Matsumoto MD, FRCSC
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  2. Margaret S. Pearle MD, PhD, EARLE
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Editor information

Editors and Affiliations

  1. The University of Wisconsin Medical School, Madison, WI

    Stephen Y. Nakada MD

  2. The University of Texas Southwestern Medical Center, Dallas, TX

    Margaret S. Pearle MD, PhD

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© 2006 Humana Press Inc., Totowa, NJ

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Matsumoto, E.D., Pearle, M.S. (2006). Treatment of Caliceal Diverticula. In: Nakada, S.Y., Pearle, M.S. (eds) Advanced Endourology. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-59259-954-7_14

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  • DOI: https://doi.org/10.1007/978-1-59259-954-7_14

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-446-3

  • Online ISBN: 978-1-59259-954-7

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