open access

Vol 81, No 2 (2022)
Original article
Submitted: 2021-03-11
Accepted: 2021-03-28
Published online: 2021-04-13
Get Citation

The evaluation of morphology of renal pelvicalyceal system’s and infundibulopelvic anatomy of kidney’s lower pole in post-mortem series

R. Çiçek1, G. Dündar2, K. Gökçen3, G. Gökçe4, E. Y. Gültekin4
DOI: 10.5603/FM.a2021.0041
·
Pubmed: 33899205
·
Folia Morphol 2022;81(2):350-358.
Affiliations
  1. Department of Urology, Malatya Training and Research Hospital, Malatya, Turkey
  2. Department of Urology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
  3. Department of Urology, Bahçeşehir University, Medical Park Göztepe Hospital, Istanbul, Turkey
  4. Department of Urology, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey

open access

Vol 81, No 2 (2022)
ORIGINAL ARTICLES
Submitted: 2021-03-11
Accepted: 2021-03-28
Published online: 2021-04-13

Abstract

Background: Urinary system stones are frequently encountered in the community. Together with technological developments, introduction of new treatment procedures such as extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy and retrograde intrarenal surgery has further reduced morbidity, mortality and hospitalisation time of patients. In order to maximise success and to reduce complications of these procedures, it is necessary to evaluate anatomy and morphological differences of kidney collector system before the procedure. This study was conducted for the purpose of determining the morphology of the kidney collector system and the negative anatomic factors of the lower pole in autopsy cases performed in our institution.
Materials and methods: Eighty two kidney units obtained from 41 autopsy cases conducted in Faculty of Medicine Department of Forensic Medicine, Sivas Cumhuriyet University between September 2017 and September 2018 were included in the study. Percentages were found as 78% for intrarenal pelvis, 13.4% for borderline pelvis, 6.1% for extrarenal pelvis and 2.4% for pelvic nonexistence. When pelvicalyceal anatomy was evaluated, percentages were found as 32.9% for bicalyceal, 26.8% for tricalyceal, 20.7% for multicalyceal, and 19.5% for unclassified calyceality. When it was evaluated according to opening of calyces into the renal pelvis based on Sampaio classification, percentages were found as 30.5% for AI, 17.1% for type II, 28% for BI, 18.3% for BII, and 6.1% for unevaluated part. Infundibular lengths of kidney’s lower pole were detected as under 3 cm in 39% and over 3 cm in 61% of all cases. Infundibulopelvic angles of kidney’s lower pole were measured as under 70o in 42.7% and over 70o in 57.3% of all cases.
Results: In our study, there was no statistically significant difference between the right and left kidneys in terms of collecting system morphology and lower pole’s negative anatomical factors. Only infundibular length which is one of the collecting system morphology and lower pole’s negative anatomical factors were statistically shorter in females than males. There was no difference in terms of other parameters.
Conclusions: In conclusion, the findings of this study are largely consistent with the results of similar studies. This reveals that renal collecting system morphology and negative anatomic factors in the lower pole collecting system in human are roughly similar. In clinical practice, pre-treatment computed tomography and, if necessary, magnetic resonance urography evaluation of the lower pole negative anatomic factors may contribute to gain preliminary information about both the clearance of stone fragments especially after shock wave lithotripsy and retrograde intrarenal surgery procedures and perioperative complications proactively.

Abstract

Background: Urinary system stones are frequently encountered in the community. Together with technological developments, introduction of new treatment procedures such as extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy and retrograde intrarenal surgery has further reduced morbidity, mortality and hospitalisation time of patients. In order to maximise success and to reduce complications of these procedures, it is necessary to evaluate anatomy and morphological differences of kidney collector system before the procedure. This study was conducted for the purpose of determining the morphology of the kidney collector system and the negative anatomic factors of the lower pole in autopsy cases performed in our institution.
Materials and methods: Eighty two kidney units obtained from 41 autopsy cases conducted in Faculty of Medicine Department of Forensic Medicine, Sivas Cumhuriyet University between September 2017 and September 2018 were included in the study. Percentages were found as 78% for intrarenal pelvis, 13.4% for borderline pelvis, 6.1% for extrarenal pelvis and 2.4% for pelvic nonexistence. When pelvicalyceal anatomy was evaluated, percentages were found as 32.9% for bicalyceal, 26.8% for tricalyceal, 20.7% for multicalyceal, and 19.5% for unclassified calyceality. When it was evaluated according to opening of calyces into the renal pelvis based on Sampaio classification, percentages were found as 30.5% for AI, 17.1% for type II, 28% for BI, 18.3% for BII, and 6.1% for unevaluated part. Infundibular lengths of kidney’s lower pole were detected as under 3 cm in 39% and over 3 cm in 61% of all cases. Infundibulopelvic angles of kidney’s lower pole were measured as under 70o in 42.7% and over 70o in 57.3% of all cases.
Results: In our study, there was no statistically significant difference between the right and left kidneys in terms of collecting system morphology and lower pole’s negative anatomical factors. Only infundibular length which is one of the collecting system morphology and lower pole’s negative anatomical factors were statistically shorter in females than males. There was no difference in terms of other parameters.
Conclusions: In conclusion, the findings of this study are largely consistent with the results of similar studies. This reveals that renal collecting system morphology and negative anatomic factors in the lower pole collecting system in human are roughly similar. In clinical practice, pre-treatment computed tomography and, if necessary, magnetic resonance urography evaluation of the lower pole negative anatomic factors may contribute to gain preliminary information about both the clearance of stone fragments especially after shock wave lithotripsy and retrograde intrarenal surgery procedures and perioperative complications proactively.

Get Citation

Keywords

infundibulopelvic angle, infundibulopelvic anatomy, kidney anatomy, post-mortem morphology, kidney morphology, urology

About this article
Title

The evaluation of morphology of renal pelvicalyceal system’s and infundibulopelvic anatomy of kidney’s lower pole in post-mortem series

Journal

Folia Morphologica

Issue

Vol 81, No 2 (2022)

Article type

Original article

Pages

350-358

Published online

2021-04-13

Page views

1367

Article views/downloads

996

DOI

10.5603/FM.a2021.0041

Pubmed

33899205

Bibliographic record

Folia Morphol 2022;81(2):350-358.

Keywords

infundibulopelvic angle
infundibulopelvic anatomy
kidney anatomy
post-mortem morphology
kidney morphology
urology

Authors

R. Çiçek
G. Dündar
K. Gökçen
G. Gökçe
E. Y. Gültekin

References (28)
  1. Anjana TSR, Muthian E, Thiagarajan S, et al. Gross morphological study of the renal pelvicalyceal patterns in human cadaveric kidneys. Indian J Urol. 2017; 33(1): 36–40.
  2. Arzoz-Fabregas M, Ibarz-Servio L, Blaco-Casares FJ. Can infindibular heiht predict the clearance of lower pole stone after extracorporeal shochwave litotripsy? J Urol. 2009; 35: 140–150.
  3. Brant WE, Helms CA. Fundamentals of diagnostic radiology. 4nd ed. Williams & Wilkins, Lippincott 2012: 817–830.
  4. Bruce SJ, Warmsley R, Ross JA. The abdominal cavity in manual of surgical anatomy. 5th ed. E and S Livingstone Ltd., Edinburgh 1967: 391–403 .
  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. Fine J, Ken EN. The arteries of the human kidney. J Anat. 1966; 100: 881–894.
  8. Fuchs AM, Fuchs GJ. Retrograde intra-renal surgery for calculus disease: new minimally invasive treatment approach. J Endourol. 1990; 4: 337–345.
  9. Gandhi KR, Chavan S. Revisiting the morphology of pelvicalyceal system in human cadaveric kidneys with a systematic review of literature. Asian J Urol. 2019; 6(3): 249–255.
  10. Geavlete P, Multescu R, Geavlete B. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopic approach. J Endourol. 2008; 22(10): 2235–2239.
  11. Ghoneim IA, Ziada AM, Elkatib SE. Predictive factors of lower caliceal stone clearance after extracorporeal shock wave lithotripsy (ESWL): A focus on infundibulopelvic anatomy. Eur Urol. 2005; 48: 296–302.
  12. Grasso M, Ficazzola M. Retrograde ureteropyeloscopy for lower pole caliceal calculi. J Urol. 1999; 162(6): 1904–1908.
  13. Hakan K, Yurdaer K, Yakup K, et al. Unfavorable anatomical factors influencing the success of retrograde intra- renal surgery for lower pole renal calculi. Urology J. 2015; 12: 2065–2066.
  14. Jessen JP, Honeck P, Knoll T, et al. Flexible ureterorenoscopy for lower pole stones: influence of the collecting system's anatomy. J Endourol. 2014; 28(2): 146–151.
  15. Krishnaveni C, Kulkarni R, Kishore Kumar BN. A study of renal calyces by using barium contrast. Int J Anat Res . 2014; 2: 369–374.
  16. Lingerman JE, Matlaga BR, Evan AP. Surgical management of upper urinary tract calculi, Wein AJ, Kavoussi LR , Nowick AC, Partin AW, Peters CA (Eds), Campbell-Walsh Urology. 10th ed. Elsevier Saunders, Philadelphia 2012: 1431–1507.
  17. 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.
  18. Marroig B, Favorito LA, Fortes MA. Lower pole anatomy and mid-renal-zone classification applied to flexible ureteroscopy: experimental study using human three-dimensional endocasts. Surg Radiol Anat. 2015; 37: 1243–1249.
  19. Ningthoujam DD, Chongtham RD, Sinam SS. Pelvi-calyceal pattern in foetal and adult human kidneys. J Anat Soc India. 2005; 54: 1–11.
  20. Pace KT, Weir MJ, Harju M, et al. Individual patient variation and inter-rater reliability of lower calyceal infundibular width on routine intravenous pyelography. BJU Int. 2003; 92(6): 607–609.
  21. Pearle MS, Lotan Y. Urinary lithiasis, etiology, epidemiology, and pathogenesis. In Wein AJ (Ed). Campbell-Walsh Urology. 10th ed. Elsevier Saunders, Philadelphia 2012: 1257–1287.
  22. Pollack HM, McClennan BL. Clinical Urography. 2nd ed. Vol. 1. W.B. Saunders Company, Philadelphia 2000: 764–892.
  23. 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.
  24. 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.
  25. Sahinkanat T, Ekerbicer H, Onal B, et al. Evaluation of the effects of relationships between main spatial lower pole calyceal anatomic factors on the success of shock-wave lithotripsy in patients with lower pole kidney stones. Urology. 2008; 71(5): 801–805.
  26. Sampaio FJ, Mandarim-De-Lacerda CA. Anatomic classification of the kidney collecting system for endourologic procedures. J Endourol. 1988; 2(3): 247–251.
  27. Sari S, Ozok HU, Topaloglu H, et al. The association of a number of anatomical factors with the success of retrograde intrarenal surgery in lower calyceal stones. Urol J. 2017; 14(4): 4008–4014.
  28. 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.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl