Current Concepts in the Management of Pyelocaliceal Diverticula

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Abstract
In 17 patients with 18 caliceal diverticula ranging in diameter from 1.1 to 7.5 cm, percutaneous techniques were used to obliterate the abnormality and remove any associated stones. In most cases, direct puncture of the diverticulum was performed with the aid of C-arm fluoroscopy. In most cases, dilating the neck of the diverticulum and leaving a large nephrostomy tube in place for 2 weeks promoted the formation of sufficient granulation tissue to obliterate the cavity. In one patient, the entire wall of the diverticulum was fulgurated with a ball electrode using coagulating current. Complications were few, and the mean hospital stay was 4.4 days. Diverticula were absent in 12 of the 15 patients available for follow-up. All three failures occurred when diverticula were approached indirectly with the flexible nephroscope instead of being punctured directly.