Lower pole stones (LPS) account for approximately 35 of renal calculi and may remain asymptomatic in many patients. Additionally, 50 of the affected patients will experience a recurrence during their lifetime. This obstruction usually requires immediate surgery or another medical. Clinical symptoms, mainly renal pain, develop in approximately 50 of urinary stone patients and require intervention. Finally, patients with lower pole stones larger than 2 cm are best served with percutaneous nephrostolithotomy, as the morbidity in experienced hands is low and stone-free rates are unequivocally higher than those of other treatment modalities.Ī variety of factors, including patient body habitus, local renal anatomy, cost and patient preference, must be taken into consideration when determining the optimal treatment modality for lower pole renal calculi. Particular medications can also increase the risk of kidney stone formation. Lower pole stones 1-2 cm in diameter are best managed with percutaneous nephrostolithotomy, although ureteroscopy is an option in select patients, particularly those not considered candidates for percutaneous nephrostolithotomy. 1, 2 Worldwide, it is also increasing in Europe and. Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions. Blood tests may reveal too much calcium or uric acid in your blood. Shock wave lithotripsy and ureteroscopy have similar stone-free rates, although shock wave lithotripsy may be preferable due to more favorable secondary outcomes. The prevalence of nephrolithiasis (kidney stones) is increasing in the United States, from one in 20 adults in 1994 to one in 11 adults in 2010. If your doctor suspects that you have a kidney stone, you may have diagnostic tests and procedures, such as: Blood testing. Patients electing expectant management should be counseled regarding the potential for stone-related symptom progression and need for future intervention. The anatomy of the collecting system may influence the treatment outcome for kidney stones ().Sampaio and Aragão, in 1992, described the lower pole spatial calyceal anatomy using an endocast and suggested that some anatomic features could impact fragment clearance ().Sampaio et al. Lower pole stones smaller than 1 cm in diameter can be managed with observation, shock wave lithotripsy or ureteroscopy. Shock wave lithotripsy, ureteroscopy and percutaneous nephrostolithotomy all constitute viable therapeutic options in select patients. The optimal treatment of lower pole renal calculi is controversial.
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