FATE OF LOWER POLE STONE LESS THAN 2 CM, A PROSPECTIVE STUDY AT TICKRIT TEACHING HOSPITAL
Journal Title: World Journal of Pharmaceutical and Medical Research - Year 2017, Vol 3, Issue 9
Abstract
Objective: This study was done to determine the fate of lower pole renal stones less than 2 cm in diameter and factors that impeded the passage of this stone which include lower pole anatomy, renal morphology, stone size, and stone nature. Patients and Methods: 150 patients with lower pole renal stones less than 2 cm in diameter were followed up prospectively at Tickrit Teaching Hospital.113 patients were chosen for this study having complete data with age range between 15-75 years. All patients had been assessed by history, good physical examination and investigation, which include general urine examination (G.U.E), blood test, ultrasonagraphy (U/S) for kidney, urethra, and bladder, and intravenous polygraph (IVP). Stone Free State asses by U/S for kidney, urethra, and bladder (K.U.B) and stone free correlate with lower pole infudibular length, width in mm as well as infundibulopelvic angle Statistical significant of each factor were correlated with stone free rate using Chi-square test. Results: overall stone free rate in our study was 70% (79 patients were stone free whether spontaneous or after extracorporal shocke wave lithotripsy (ESWL).Thirty two patients were spontaneously passage of stone within six months, while forty seven patients were passage of stone after ESWL. Mean lower infundiblar length ± SD was 29.9±6.56 mm, mean width was 5.65±2.34 mm. lower pole infundibulopelvic angle was 48.33±14.84 degree.In fifty (44.2%) and sixty three (55.7%) patien infundibular length were greater than 30 mm and 30mm or less respectively, infundibular width was greater than 5mm and 5mm or less in forty seven (41.5%) and sixty six (58.4%) patients respectively, no obtuse infundibulopeivic angle were noted. None of three lower pole anatomical factor had statistically significant impact on the stone free rate. Renal morphology significantly affecting the stone free rate since stone clearance was less than pyelonephritic kidney (P≤0.01). Also stone size had significantly (P≤ 0.00001) impact on stone clearance, small stone had better clearance than larger one. Stone nature whether the stone first attack or recurrent also affecting stone free rate since clearance was less in recurrent stone whether after ESWL of stone in another part of the kidney or after open surgery (P≤0.46). Conclusion: different in the intrarenal anatomy of the lower pole have no significant impact on stone clearance. Renal morphology, stone size, and stone nature significantly affected stone free rate.
Authors and Affiliations
Dr. Mohammed A. Rajab
Keywords
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