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. 2014 Jan;30(1):92-8.
doi: 10.4103/0970-1591.124214.

Managing caliceal stones

Andreas J Gross  1 , Sophie Knipper  1 , Christopher Netsch  1
Affiliations

Managing caliceal stones

Andreas J Gross et al. Indian J Urol. 2014 Jan.

Abstract

The natural course of untreated asymptomatic caliceal calculi has not been clearly defined, especially in terms of disease progression, and the indications for and outcomes of surgical intervention are not precise. Caliceal stones may remain asymptomatic but, in case of migration, ureteral calculi can cause acute ureteric colic with severe complications. The decision for an active treatment of caliceal calculi is based on stone composition, stone size and symptoms. Extracorporal shock-wave lithotripsy (ESWL) has a low complication rate and is recommended by the current guidelines of the European Association of Urology as a first-line therapy for the treatment of caliceal stones <2 cm in diameter. However, immediate stone removal is not achieved with ESWL. The primary stone-free rates (SFR) after ESWL depend on stone site and composition and, especially for lower pole calculi, the SFR differ widely from other caliceal stones. Minimally-invasive procedures including percutaneous nephrolithotomy and ureteroscopy are alternatives for the treatment of caliceal stones, associated with low morbidity and high primary SFR when performed in centers of excellence.

Keywords: Caliceal stones; extracorporeal shock-wave lithotripsy; percutaneous nephrolithotomy; ureteroscopy.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Treatment algorithm according to the EAU guidelines
See this image and copyright information in PMC

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