Häcker A et al, 2012: [Controversy on lower pole stones: monitor or intervene?]
Häcker A, Michel MS
Klinik für Urologie, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68135 Mannheim, Deutschland
For many years, the treatment options of lower pole stones have been discussed controversially: Watchful waiting, shock wave lithotripsy, flexible ureterorenoscopy and percutaneous litholapaxy. Small lower pole stones have been discussed controversially: Watchful waiting, shock wave lithotripsy, flexible ureterorenoscopy and percutaneous litholapaxy. Small lower pole stones <1 cm can be monitored actively. Shock waves can disintegrate the stones and are recommended for stones <1 cm. However, the stone-free rate is limited because of the particular anatomy of the lower pole. Modern flexible ureterorenoscopes can nowadays reach even anatomically unfavourable lower calyxes. For stones 2 cm percutaneous nephrolithotomy (PNL) is the standard treatment modality.
Urologe A. 2012 Mar;51(3):368-71. doi: 10.1007/s00120-012-2806-9
PMID: 22350016 [PubMed - in process]
In this German article the authors discuss different treatment alternatives for lower calyx stones. The various aspects are not new but they might serve as a summary of what presently is discussed in the literature. A conservative approach for asymptomatic