Objective: To evaluate the gravity effect of radiographic anatomic features on the stone clearance following satisfactory fragmentation of lower pole stones.

Material and Methods: Thirty three patients with mean age 39.47+12.62 years, who underwent SWL due to lower pole calculi  between October 2005 and Augusts 2009 were enrolled. The mean calculi load was 144.94+105.16 mm².  Three angles on excretory urography were measured; the inner angle between the axis of the lower pole infundibular and ureteropelvic axis (angle I= 67.00+8.47), inner angle between lower pole infundibular axis and main axis of pelvis-ureteropelvic  junction point (angle II=108.58+12.68) and inner angle between lower pole  infundibular axis and perpendicular line (angle III=46.58+8.67).  The mean number of sessions was 3.59+1.54 and the mean number of shock waves was 9346.52+4745. Hydronephrosis was presented in 12 patients.

Results: The over all success rate was %75.75. Only  angle I and angle II, had significant effect on stone clearance. While angle III, sessions number, shock waves number and stone burden, presence of hydronephrosis ,sex and age  had not significant influence on stone clearance.  

Conclusions: Radiographic anatomic features have significant role in determining the stone-free rate following satisfactory fragmentation. However angle III which  reflect the gravity effect  on the retention of the fragments in lower pole had not significant effect. Therefore  gravity effect is not enough to justify the significant influence of the radiographic anatomic features on the stone clearance and fragments retention after SWL. Further mechanisms should be  exist which may play role in retention of the fragments  after SWL.

Conference Title

6the EUA 6th South Eastern Urology Meeting, Istanbul,Turkey,1-2 October, 2010.

Conference Country

Palestine

Conference Date

Jan. 1, 2010 - Jan. 1, 2010

Conference Sponsor

EAU