Renal Stones/ renal colic

Q The best modality for treating lower pole renal calculus 1.5 cm in size is

a) ESWL (Extra Corporeal Shock Wave Lithotripsy ( ESWL)
b) Percutaneous  Nephrolithotomy ( PCNL)
c) Pyelolithotomy
d) Neohrolithotomy







Answer
b

Stone location as well as size is known to have an important bearing on choosing the modality for treatment of renal calculi. ESWL is not so successful in clearing lower pole calculi because of limited clearance of fragments from the dependent lower pole of kidney.
European association of Urological guidelines for stones recommend PCNL for stones more than 2 cm anywhere and more than 1.5 cm in lower pole calyces.