Knoll T et al, 2011: Treatment of small lower pole calculi--SWL vs. URS vs. PNL?
Knoll T, Tasca A, Buchholz NP
Department of Urology, Sindelfingen-Boeblingen Medical Center, University of Tübingen, Germany.
According to current guideline recommendations extracorporeal shock wave lithotripsy (SWL) remains the first choice treatment for small and mid-sized renal calculi. However, the results of SWL treatment for lower pole stones can be disappointing whilst more invasive endoscopic modalities, such as flexible ureterorenoscopy (fURS) and percutaneous nephrolithotomy (PNL) are often considered more effective. This article summarizes a point-counterpoint discussion at the 9th eULIS symposium in Como, Italy, and discusses the potential advantages and disadvantages of the different therapeutic approaches.
Arch Ital Urol Androl. 2011 Mar;83(1):6-9
PMID: 21585161 [PubMed - indexed for MEDLINE]
This article summarizes a poin-counterpoint discussion on the most appropriate treatment of small lower pole renal stones. The most important conclusions from the underlying literature review were that the results of URS (RIRS) and ESWL in terms of stone-free rates are similar and that PNL gives a better stone rate, but at the expense of a much higher invasiveness. The bottom-line of the discussion was that for small (<=10 mm) lower calyx stones, ESWL remains the method of choice.