Ureteroscopy Successful for Range of Kidney Stones

No significant difference in clearance rates for stones in upper, middle and lower poles

THURSDAY, March 13 (HealthDay News) -- Ureteroscopy is a safe and effective treatment for nephrolithiasis, even for the particularly challenging lower pole stones, which responded with similar clearance rates as stones in the upper and middle poles, according to an article published in the February issue of Urology.

Adam E. Perlmutter, of West Virginia University in Morgantown, W.Va., and colleagues analyzed data from 84 adult patients who had 86 stones (4 mm to 20 mm in size) that were treated with ureteroscopy and laser lithotripsy.

The researchers report that 81 of the stones (94.2 percent) were completely cleared, with no significant difference in clearance rates between stones in the upper, middle and lower poles. There were no significant differences in the composition of stones when stratified by location, the report indicates.

"The treatment of lower pole stones differs from the treatment of upper pole and middle pole nephrolithiasis, because stones in the lower pole have to ascend up the lower pole infundibulum, pass into the renal pelvis, and then exit the kidney down the ureter.…Other than caliceal diverticular stones, lower pole stones present the greatest challenge to urologists treating nephrolithiasis," the authors write. "The results of our study have shown that ureteroscopy can safely and effectively treat lower pole stones up to 2 cm in size with success rates greater than 90 percent."

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