Flexible Ureterorenoscopy, Dilatation of Narrow Caliceal Neck, and ESWL: A New, Minimally Invasive Approach to Stones in Caliceal Diverticula

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Abstract
Between January and December 1988, 15 patients with symptomatic stones in caliceal diverticula or nonvisible calices received treatment at the UCLA Stone Center. All patients were further evaluated with flexible ureterorenoscopy to identify narrow intrarenal segments. Dilatation of narrow intrarenal segments was performed along with direct endoscopic stone removal, extracorporeal shock wave lithotripsy (ESWL), or both under the same anesthesia. In all cases, access to the targeted cavity was gained and dilatation of the narrow connection was successfully performed. Eleven of the patients were rendered completely stone free; two of four with residual debris remained symptom free. No complications from the endoscopic procedures or the ESWL treatments were noted.