Shock-wave lithotripsy for lower calyceal stones 1to2 centimetres in size - Out-dated or still standard of care

Introduction - Shock-wave lithotripsy is the traditional treatment for lower calyceal stones 1-2cm in size however newer options are emerging. We performed this study to determine the efficacy of lithotripsy in this category of patients and to determine whether anatomical factors played any role. Methods - All adult patients with solitary lower calyceal stones 1-2cm in size undergoing lithotripsy in the calendar year 2012 were included. Success was defined as complete clearance or presence of clinically insignificant residual fragments 4mm. Anatomic factors studied were calyceal length, infundibular width, indundibulo-pelvic angle and presence of compound calyces. Results - A total of 37 cases were included. Overall success rate was 64.8percent at 4 weeks with over half achieving complete clearance. Effectiveness quotient was 35.1percent. There was no significant effect of anatomical factors and only 3 patients required ancillary procedures. Conclusion - Lithotripsy remains a safe and effective option for this class of patients. Anatomical factors did not predict clearance in our study.