📃 Paper Title: Management of lower pole nephrolithiasis: a critical analysis
🧍 Author: J E Lingeman
🕒 Year: 1994
📚 Journal: The Journal of Urology
🌎 Country: USA
ㅤContext to the study:
Can you tell me about a study that highlights the higher efficacy of percutaneous nephrolithotomy (PCNL) for treating lower pole nephrolithiasis when compared with Extracorporeal shock wave lithotripsy (ESWL)?
ㅤ✅ Take-home message of study:
Percutaneous nephrostolithotomy (PCNL) provides better stone-free rates (SFR) for the treatment of lower pole nephrolithiasis than Extracorporeal shock wave lithotripsy (ESWL); 90% vs 60%.
ㅤ Meta-analysis
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Study participants:
Number of studies included 16 (13 ESWL, 3 PCNL)
Inclusion criteria:
Management of lower pole stones
Between 1986 - 1992
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Key study outcomes:
**Stone Free Rates: **
Stone size less than 10mm
ESWL - 74%
PCNL 100%
Stone size 10 to 20mm
ESWL - 56%
PCNL 89%
Stone size more than 20mm
ESWL - 33%
PCNL 94%
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Study Limitations:
Lack of uniformity in assessment of treatment outcome - XR/CT/US
Lack of uniformity in treatment standards - Different lithotripters
Lack of consensus in treatment success - Stone-free vs Clinically insignificant
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