open access

Vol 77, No 1 (2018)
ORIGINAL ARTICLES
Published online: 2017-06-20
Submitted: 2017-04-02
Accepted: 2017-05-12
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The impact of pelvicalyceal anatomy on the stone formation in patients with lower pole renal stones

K. Balawender, S. Orkisz
DOI: 10.5603/FM.a2017.0058
·
Pubmed: 28653304
·
Folia Morphol 2018;77(1):16-21.

open access

Vol 77, No 1 (2018)
ORIGINAL ARTICLES
Published online: 2017-06-20
Submitted: 2017-04-02
Accepted: 2017-05-12

Abstract

Background: The aim of our study was to determine whether various anatomic factors constitute a predisposition to a lower pole renal stones.

Materials and methods: We analysed the computed tomography (CT) urography of 75 patients with a single lower pole stone. Measurements were taken of the infundibulopelvic angle (IPA), infundibular width (IW), infundibular length (IL) and calyceopelvic height (CPH).

Results: The mean patient age was 50 years (range 17–79 years). The mean stone size was 11.9 mm. The mean IPA using Sampaio method in affected kidney was 113.4 ± 15.3o (range 80–139o), 59.5 ± 17.3o using Elbahnasy method. The values of IPA on the contralateral kidney were 119.86 ± 15.37o (range 79–141o; p = = 0.001) using Sampaio method of measurement and 59.78 ± 12o (range 34–90 o; p = 0.465) using the method described by Elbahnasy. We reported statistically significant differences between stone-bearing kidney and contralateral kidney in measurement IPA using only Sampaio method. The mean infundibular width was 4.22 ± 1.81 mm on the affected kidney and 3.72 ± 2.5 mm on the contralateral side (p = 0.164). The mean infundibular length was 15.37 ± 4.57 mm on the affected kidney and 14.66 ± 4.35 mm on the unaffected side (p = 0.329). The CPH was 10.19 ± 4.05 mm on the affected kidney and 10.44 ± 3.83 mm on the normal side (p = 0.688).

Conclusions: Pelvicalyceal morphology of the kidney is one of the factors that determine the risk of developing kidney stones. Out of the analysed morphological parameters of kidney IPA is a statistically significant risk factor to form lower pole kidney stones. Other anatomic parameters did not seem to have a significant role in predisposing to form lower pole kidney stone. (Folia Morphol 2018; 77, 1: 16–21)  

Abstract

Background: The aim of our study was to determine whether various anatomic factors constitute a predisposition to a lower pole renal stones.

Materials and methods: We analysed the computed tomography (CT) urography of 75 patients with a single lower pole stone. Measurements were taken of the infundibulopelvic angle (IPA), infundibular width (IW), infundibular length (IL) and calyceopelvic height (CPH).

Results: The mean patient age was 50 years (range 17–79 years). The mean stone size was 11.9 mm. The mean IPA using Sampaio method in affected kidney was 113.4 ± 15.3o (range 80–139o), 59.5 ± 17.3o using Elbahnasy method. The values of IPA on the contralateral kidney were 119.86 ± 15.37o (range 79–141o; p = = 0.001) using Sampaio method of measurement and 59.78 ± 12o (range 34–90 o; p = 0.465) using the method described by Elbahnasy. We reported statistically significant differences between stone-bearing kidney and contralateral kidney in measurement IPA using only Sampaio method. The mean infundibular width was 4.22 ± 1.81 mm on the affected kidney and 3.72 ± 2.5 mm on the contralateral side (p = 0.164). The mean infundibular length was 15.37 ± 4.57 mm on the affected kidney and 14.66 ± 4.35 mm on the unaffected side (p = 0.329). The CPH was 10.19 ± 4.05 mm on the affected kidney and 10.44 ± 3.83 mm on the normal side (p = 0.688).

Conclusions: Pelvicalyceal morphology of the kidney is one of the factors that determine the risk of developing kidney stones. Out of the analysed morphological parameters of kidney IPA is a statistically significant risk factor to form lower pole kidney stones. Other anatomic parameters did not seem to have a significant role in predisposing to form lower pole kidney stone. (Folia Morphol 2018; 77, 1: 16–21)  

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Keywords

anatomy of lower calyx, urolithiasis, extracorporeal shock wave lithotripsy (ESWL) procedure

About this article
Title

The impact of pelvicalyceal anatomy on the stone formation in patients with lower pole renal stones

Journal

Folia Morphologica

Issue

Vol 77, No 1 (2018)

Pages

16-21

Published online

2017-06-20

DOI

10.5603/FM.a2017.0058

Pubmed

28653304

Bibliographic record

Folia Morphol 2018;77(1):16-21.

Keywords

anatomy of lower calyx
urolithiasis
extracorporeal shock wave lithotripsy (ESWL) procedure

Authors

K. Balawender
S. Orkisz

References (24)
  1. Ahlstrand C, Tiselius HG. Recurrences during a 10-year follow-up after first renal stone episode. Urol Res. 1990; 18(6): 397–399.
  2. Albala DM, Assimos DG, Clayman RV, et al. Lower pole I: a prospective randomized trial of extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy for lower pole nephrolithiasis-initial results. J Urol. 2001; 166(6): 2072–2080.
  3. Basiri A, Tabibi A, Nouralizadeh A, et al. Comparison of safety and efficacy of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in patients with renal pelvic stones: a randomized clinical trial. Urol J. 2014; 11(6): 1932–1937.
  4. Bernardo NO, Smith AD. Chemolysis of urinary calculi. Urol Clin North Am. 2000; 27(2): 355–365.
  5. Danuser H, Müller R, Descoeudres B, et al. Extracorporeal shock wave lithotripsy of lower calyx calculi: how much is treatment outcome influenced by the anatomy of the collecting system? Eur Urol. 2007; 52(2): 539–546.
  6. Elbahnasy AM, Shalhav AL, Hoenig DM, et al. Lower caliceal stone clearance after shock wave lithotripsy or ureteroscopy: the impact of lower pole radiographic anatomy. J Urol. 1998; 159(3): 676–682.
  7. Fong YK, Peh SO, Ho SH, et al. Lower pole ratio: a new and accurate predictor of lower pole stone clearance after shockwave lithotripsy? Int J Urol. 2004; 11(9): 700–703.
  8. Gurocak S, Kupeli B, Acar C, et al. Is the difference of stone clearance after shockwave lithotripsy for lower caliceal stones between adult and paediatric age groups influenced by the difference of lower caliceal anatomical variations? Eur Urol Suppl. 2005; 4(3): 45.
  9. Keeley FX, Moussa SA, Smith G, et al. Clearance of lower-pole stones following shock wave lithotripsy: effect of infunibulopelvic angle. Eur Urol. 1999; 36: 371–375.
  10. Kupeli B, Tunc L, Acar C, et al. The impact of pelvicaliceal anatomical variation between the stone-bearing and normal contralateral kidney on stone formation in adult patients with lower caliceal stones. Int Braz J Urol. 2006; 32(3): 287–92; discussion 292.
  11. Manikandan R, Gall Z, Gunendran T, et al. Do anatomic factors pose a significant risk in the formation of lower pole stones? Urology. 2007; 69(4): 620–624.
  12. Nabi G, Gupta NP, Mandal S, et al. Is infundibuloureteropelvic angle (IUPA) a significant risk factor in formation of inferior calyceal calculi? Eur Urol. 2002; 42(6): 590–593.
  13. Özgör T, Üstűnol K, Ilker S, et al. The impact of radiological anatomy in clearance of lower calyceal stones after Extracoropreal Shock wave Lithotripsy in paediatric patients. Eur Urol. 2002; 43: 188–193.
  14. Prakash J, Singh V, Kumar M, et al. Retroperitoneoscopic versus open mini-incision ureterolithotomy for upper- and mid-ureteric stones: a prospective randomized study. Urolithiasis. 2014; 42(2): 133–139.
  15. Rassweiler JJ, Renner C, Chaussy C, et al. Treatment of renal stones by extracorporeal shockwave lithotripsy: an update. Eur Urol. 2001; 39(2): 187–199.
  16. Resorlu B, Oguz U, Resorlu EB, et al. The impact of pelvicaliceal anatomy on the success of retrograde intrarenal surgery in patients with lower pole renal stones. Urology. 2012; 79(1): 61–66.
  17. Ruggera L, Beltrami P, Ballario R, et al. Impact of anatomical pielocaliceal topography in the treatment of renal lower calyces stones with extracorporeal shock wave lithotripsy. Int J Urol. 2005; 12(6): 525–532.
  18. Sampaio FJ, Aragao AH. Inferior pole collecting system anatomy: its probable role in extracorporeal shock wave lithotripsy. J Urol. 1992; 147(2): 322–324.
  19. Sampaio FJ, D'Anunciação AL, Silva EC. Comparative follow-up of patients with acute and obtuse infundibulum-pelvic angle submitted to extracorporeal shockwave lithotripsy for lower caliceal stones: preliminary report and proposed study design. J Endourol. 1997; 11(3): 157–161.
  20. Singh V, Sinha RJ, Gupta DK, et al. Prospective randomized comparison of retroperitoneoscopic pyelolithotomy versus percutaneous nephrolithotomy for solitary large pelvic kidney stones. Urol Int. 2014; 92(4): 392–395.
  21. Sorensen CM, Chandhoke PS. Is lower pole caliceal anatomy predictive of extracorporeal shock wave lithotripsy success for primary lower pole kidney stones? J Urol. 2002; 168(6): 2377–82; discussion 2382.
  22. Sumino Y, Mimata H, Tasaki Y, et al. Predictors of lower pole renal stone clearance after extracorporeal shock wave lithotripsy. J Urol. 2002; 168(4 Pt 1): 1344–1347.
  23. Tiselius HG. Who Forms Stones and Why? Eur Urol Suppl. 2011; 10(5): 408–414.
  24. Tuckey J, Devasia A, Murthy L, et al. Is there a simpler method for predicting lower pole stone clearance after shockwave lithotripsy than measuring infundibulopelvic angle? J Endourol. 2000; 14(6): 475–478.

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