Treatment of Lower Pole Renal Stones-Extracorporeal Shock Wave Lithotripsy vs Endourology. A literature review

Urolithiasis is a subject of great interest in the urological world nowadays, due to the increasing incidence of the disease caused by the metabolic disorders that arise from the modern lifestyle, which is often not beneficial to the human body. Also, pathology is intensely debated because its treatment involves significant costs for society. The present article aims to compare the endourological treatment methods with extracorporeal shock waves lithotripsy for lower calyceal lithiasis, which is an intensely debated topic, and the opinions are divided regarding the choice of the optimal method for the management of this pathology. The location of the stone at the level of the inferior calyceal group implies a difficult approach regardless of the chosen treatment method, but also a poor excretion of the remaining fragments, frequently encountering a lower stone-free rate. Thus, the treatment methods were compared, taking into account the anatomic factors, the size of the stone, its hardness, the risk of the occurrence of intraoperative or postoperative complications, the necessity of a possible reintervention and the duration of the intervention. Last but not least, the patient’s preference must be taken into account, obviously, after a physician-patient dialogue explaining to the patient the individual treatment, and being guided to the optimal therapy for the patient. Keywords: urinary lithiasis, lower pole stones, extracorporeal shockwave lithotripsy, flexible ureterorenoscopy, percutaneous nephrolithotomy