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Extracorporeal shockwave lithotripsy in anomalous kidneys
1Department of Urology, Gazi University School of Medicine, Ankara, Turkey. borakupeli@hotmail.com
Journal of Endourology
|August 14, 1999
Summary
Extracorporeal shockwave lithotripsy (SWL) is effective for kidney stones in patients with congenital urinary anomalies, achieving a 70% stone-free rate. Ureteral duplication cases showed the best outcomes, while larger stones in certain anomalies may require alternative surgical interventions.
Area of Science:
- Urology
- Nephrology
- Surgical Innovation
Background:
- Extracorporeal shockwave lithotripsy (SWL) is a standard treatment for kidney stones.
- Congenital urinary system anomalies present unique challenges for stone management.
- Evaluating SWL efficacy in this specific patient population is crucial for optimizing treatment strategies.
Purpose of the Study:
- To assess the effectiveness and outcomes of SWL in patients with congenital urinary system anomalies and kidney stones.
- To identify specific anomaly types and stone characteristics that influence SWL success rates.
- To compare SWL outcomes with alternative surgical options for complex cases.
Main Methods:
- A retrospective analysis of 120 patients with congenital urinary system anomalies and kidney stones treated with SWL.
- Categorization of patients based on anomaly type: horseshoe kidneys, rotation anomalies, pelvic kidneys, and ureteral duplications.
- Evaluation of stone-free rates, fragmentation success, and need for secondary procedures post-SWL.
Main Results:
- An overall stone-free rate of 70% was achieved across all congenital anomaly types.
- Patients with ureteral duplications demonstrated the highest stone-free rate (83%).
- Lower success rates were observed in horseshoe kidneys (68%) and malrotated kidneys (59%), with larger stones (>2 cm) impacting outcomes.
Conclusions:
- SWL is a viable and effective treatment for kidney stones in patients with congenital urinary system anomalies, particularly for stones smaller than 2 cm.
- Ureteral duplication is associated with superior SWL outcomes.
- For complex cases involving larger stones (≥3 cm) in horseshoe or malrotated kidneys and duplex systems, percutaneous nephrolithotomy or open surgery may be more appropriate.