Painful caliceal calculi. The treatment of small nonobstructing caliceal calculi in patients with symptoms

From 1984 to 1989 35 patients presented with uncharacteristic flank pain or recurrent urinary tract infections and small nonobstructing caliceal calculi. Thirty patients were treated; 13 with percutaneous stone extraction, 8 with extracorporeal shock wave lithotripsy, 3 with ureteroscopic stone manipulation and 2 by open surgery. Stone removal was successful in 39 patients and they were all relieved of their symptoms (86%). Stone size was decreased in 2 patients who felt a marked alleviation. Where the stone remained unaffected the symptoms persisted unabated. These observations suggest that small caliceal stones can cause pain. The results of treatment are such that it is justifiable to treat a small caliceal stone in patient suffering from flank pain of no other known cause.