Is There a Simpler Method for Predicting Lower Pole Stone Clearance after Shockwave Lithotripsy than Measuring Infundibulopelvic Angle?

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Abstract
Background and Purpose: Several anatomic factors influence the clearance of lower pole stones treated with shockwave lithotripsy (SWL). One of these is the infundibulopelvic angle, but its measurement is complex. Methods: We proposed a more simple measure of caliceal dependence, the caliceal pelvic height (CPH), which we defined as the distance between a horizontal line from the lowermost point of the calix containing the stone to the highest point of the lower lip of the renal pelvis. Results: In 62 patients who had SWL for solitary lower pole stones, a CPH <15 mm was associated with a stone clearance rate of 92%, whereas with a CPH ≥15 mm, the clearance rate was only 52% (p < 0.05). A majority (74%) of the patients with an infundibular width of ≥5 mm were rendered stone free compared with 40% of those with a width of <5 mm (p < 0.05). Conclusion: Measurement of the CPH, in conjunction with other anatomic factors, may more accurately predict the outcome of SWL in patients with lower pole stones.