Background To determine factors influencing the clearance of fragments after extra-corporeal shock wave lithotripsy (ESWL) for lower pole calyceal (LPC) stones. Methods In the period between July 1998 and Oct 2001, 100 patients with isolated lower polar calyceal calculi ≤ 20 mm, in patients aged ≥ 14 years, were included in the study. Intravenous urograms (IVU) were reviewed to define the LPC anatomy (width of the infundibulum and pelvicalyceal angle). Study end points i.e. stone free status; number of shock waves used and number of sessions were correlated with variables like LPC anatomy, body mass index and stone size. Results At three months follow up the clearance for stone size ≤ 10 mm, 11–15 mm and 16–20 mm were 95, 96 and 90% respectively. Patients with acute LPC (90°) had stone clearance of 94 and 100% respectively. For the infundibular width of 4 mm, it was 100%. For body mass index (BMI) less than and > 30 kg/m2, the stone clearance was 92 and 95% respectively. Conclusions There is a trend towards more ESWL sessions and shock wave requirement in patients with acute pelvi-calyceal angle and narrow infundibulum but it is not statistically significant. Size (≤ 20 mm) and BMI has no relation with stone clearance. With modern lithotripter, stones up to 20 mm could primarily be treated by ESWL, irrespective of an un-favorable lower polar calyceal anatomy and body habitus.
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机译：背景技术为确定影响下极肾盂（LPC）结石的体外冲击波碎石术（ESWL）后碎片清除的影响因素。方法在1998年7月至2001年10月期间，纳入100例年龄≥14岁的孤立的下极肾盏结石≤20 mm的患者。回顾静脉内尿路造影（IVU）以定义LPC解剖结构（漏斗宽度和骨盆底角）。研究终点，即无结石状态;使用的冲击波数量和疗程数量与LPC解剖结构，体重指数和结石大小等变量相关。结果在三个月的随访中，≤10 mm的石块的净间隙分别为95％，96％和90％的11-15mm和16-20mm。急性LPC（90°）患者的结石清除率分别为94和100％。对于4mm的漏斗状宽度，为100％。当体重指数（BMI）小于或大于30 kg / m 2 时，结石清除率分别为92％和95％。结论急性盆腔-caeceal角和漏斗狭窄的患者存在更多的ESWL疗程和冲击波需求的趋势，但无统计学意义。尺寸（≤20 mm）和BMI与石材间隙无关。使用现代碎石机，无论不利的下极肾盂解剖和身体习性如何，ESWL均可主要治疗20 mm以内的结石。
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