SWL Not As Effective for Stones in Horseshoe Kidneys
Kenneth Pace, MD, and colleagues at St. Michael's Hospital, University of Toronto, analyzed data from 46 patients with horseshoe kidneys treated at the hospital's lithotripsy unit. The patients had a total of 73 stones with a mean size of 86.8 mm2 and a mean BMI of 26.5 kg/m2. Nearly 47% of stones were in the lower calyx.
The overall single-treatment success rate at two weeks was 49.3% and stone-free rate was 30%, the researchers reported here at the Canadian Urological Association annual meeting. Thirty-five stones (47.9%) underwent an additional treatment (34 with SWL and one with percutaneous nephrolithotomy).
SWL is considered the first-line treatment for most patients with kidney stones, the researchers noted, but SWL has been poorly studied in patients with horseshoe kidneys. Based on their findings, Dr. Pace's team concluded: “SWL may be offered to patients with horseshoe kidney once limitations in stone clearance have been considered and discussed with the patient.”The researchers reported their findings here at the Canadian Urological Association Annual Meeting.