The impact of pelvicaliceal anatomical variation between the stone-bearing and normal contralateral kidney on stone formation in adult patients with lower caliceal stones

ABSTRACT

OBJECTIVE: We aimed to investigate the effect of pelvicaliceal anatomical differences on the etiology of lower caliceal stones. MATERIALS AND METHODS: Records of adult patients between January 1996 and December 2005 with solitary lower caliceal stone were reviewed. After exclusion of patients with hydronephrosis, major renal anatomic anomalies, non-calcium stones, history of recurrent stone disease and previous renal surgery, 78 patients were enrolled into the study. Lower pole infundibulopelvic angle (IPA), infundibulovertebral angle (IVA), infundibular length (IL), width (IW), number of minor calices and cortical thickness of the lower pole together with other caliceal variables obtained from the whole pelvicaliceal anatomy of both stone-bearing and contralateral normal kidneys were measured from intravenous pyelogram of the patients. Total pelvicaliceal volume was also calculated by a previously described formula for both kidneys. RESULTS: There were statistically significant difference between two kidneys in terms of IW (p < 0.001) and IL (p = 0.002) of the upper calyx, IW (p = 0.001) and IVA (p < 0.001) of the lower calyx), pelvicaliceal volume (p < 0.001), IPA of middle calyx (p = 0.006) and cortical thickness over the lower pole (p < 0.001). However there was no difference between stone-bearing and contralateral normal kidneys in terms of lower pole IPA (p = 0.864) and IL (p = 0.568). CONCLUSION: Pelvicaliceal volume but not lower caliceal properties seem to be a risk factor for stone formation in lower calyx.