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[Treatment of calcium kidney lithiasis. ESWL, NLP, open surgery]
F Boronat Tormo1, J L Pontones Moreno, E Broseta Rico
1Unidad de Litotricia, Hospital La Fe, Av. de Campanar no. 21, 46009 Valencia, España.
Objective:
To review current management of renal calcium stones.
Methods:
Data from our experience are presented and the literature is reviewed. The results and indications of treatment are analyzed.
Results/Conclusions:
Pyelic calculi are the best indication for ESWL. The success rate ranges from 33%-90% and is influenced particulary by stone size and composition. Similar results are achieved for calyceal calculi, although the overall complete resolution rate is 50%-75% for stones in the lower calyces versus 90% for PNL. Furthermore, the resolution rate is even lower if the infundibulo-pyelic angle is less than 90 degrees. The resolution rate ranges from 4%-58% for intradiverticular calculi and the best results are obtained when the calculus is small and the neck of diverticulum can be visualized at urography. The staghorn stone is the most complex and offers more difficulties to treatment by ESWL. Good results are achieved only in the staghorn type I (72% resolution; mean 3.5 sessions per patient).