Management of renal caliceal diverticular stones: A decade of experience

• Main Authors: Madhusudan Patodia, Rahul Janak Sinha, Siddharth Singh, Vishwajeet Singh
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Urology Annals
• Subjects: Caliceal diverticular stone; caliceal diverticulum; percutaneous nephrolithotomy
• Online Access: http://www.urologyannals.com/article.asp?issn=0974-7796;year=2017;volume=9;issue=2;spage=145;epage=149;aulast=Patodia

Objective: The objective of this study is to evaluate our methods for management of renal caliceal diverticular stones (CDS). Materials and Methods: We conducted a retrospective study from January 2005 to July 2015 and included patients who were treated for renal CDS. Patients were evaluated for treatment modality, puncture site (in case percutaneous nephrolithotomy [PCNL] attempted), operative time, stone clearance rate, and complications. During PCNL, if the infundibulum was found to connect the diverticulum to the calyx, then a double J stent was placed. No attempt was made to dilate the diverticular neck or to create a neoinfundibulum. Results: Twenty-four patients were treated for CDS during the study period. Two patients underwent shockwave lithotripsy, and 22 were managed by PCNL. Mean stone size was 16.37 mm (range: 6–35 mm) and mean diverticulum size was 20.62 mm (range: 12–37 mm). No fulguration was done in initial 17 patients, while fulguration by Holmium Laser was performed in the last five cases treated with PCNL. Mean operative time was 70.31 min (range: 47–90 min). Mean follow-up was 34 months, diverticulum resolved in 14 patients and reduced in size in 7 patients. Conclusion: Caliceal diverticular calculi can be treated most efficiently by PCNL. Stone-guided puncture and no attempt to dilate or create neoinfundibulum reduces operative time and morbidity while yielding high stone-free rate.