Table 4.
ESWL in anomalous kidney stone management.
| Study | Characteristics | Procedure/results | Conclusion |
|---|---|---|---|
| Tunc (2004) 11 | Aim ESWL in anomalous kidneys Study Retrospective |
Patients 150 (93 males and 57 females) Duplex kidneys: 57, HSK: 45, MRK: 30, PK/CRE:14 Stone characteristics Size: 10–30 mm average Site: upper calyx: 10, middle calyx: 5, lower calyx: 14, renal pelvis: 55, multi-calyceal 27, Others ureteric 39 Procedure Shock Wave Lithotripsy with sessions varying from 1 to 4, SFR 1 session in 58% and 4 sessions in 19% Complications Renal colic in 40 (26.6%) patients, Acute pyelonephritis in eight (5.3%) cases and stone-street formation in six (4%) |
In conclusion, considering the low morbidity and high success rate, SWL is an effective method for stones < 20 mm in all anomalous kidneys, with stone burden, stone localization, and severity of the anomaly seeming to be the main parameters impacting treatment success |
| Sheir (2003) 12 | Aim ESWL in anomalous kidneys Study Retrospective |
Patients 198 (169 males and 29 females) HSK: 49, MRK: 120, Duplex: 29 Stone characteristics Size: 11–20 mm average Site: upper calyx: 16, middle calyx: 16, lower calyx: 70, renal pelvis: 71, multi-calyceal 25 Procedure SWL with sessions varying from 1 to 6 1 session in 35% and 6 sessions in 5.6% Complications Hematuria, renal colic, Steinstrasse, no perirenal hematoma |
ESWL is an effective and reliable treatment method in patients with congenital urinary system anomalies. Stone burden (size and number) is the most significant factor influencing the stone-free rate. ESWL should be the primary method of therapy in such patients, especially when the stones are <20 mm. The use of prone positioning may facilitate stone localization, and the use of second-generation lithotripters improves the treatment of these patients with multiple sessions |
CFRE, crossed fused renal ectopia; EK, ectopic kidney; ESWL, extracorporeal shock wave lithotripsy; HSK, horseshoe kidneys; MRK, Mal-rotated kidneys; PCNL, percutaneous nephrolithotomy; PK, pelvic kidney; RIRS, retrograde intra-renal surgery; SFR, stone-free rate; URS, ureterorenoscopy.