ABSTRACT

The optimal treatment of lower pole stone in kidney is controversial. Shock wave lithotripsy (SWL), flexible ureterorenoscopy (F-URS) or retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomi (PNL) are widely used therapeutic options for lower pole stone. Open surgery and laparoscopic surgery are rarely used modalities. The goal of the treatment is to achieve stone clearance taking into account the clinical features of the patient and urinary system stone properties. Pelvicaliceal anatomical properties influence selection of therapeutic options and success of the treatment. Presence or absence of hydronephrosis, length and width of caliceal neck, association between ureter and pelvicaliceal system are important anatomical factors. Today, SWL is first-line treatment modality for kidney stones smaller than 20 mm and PNL for kidney stones larger than 20 mm. Flexible ureterorenoscopy is used for lower pole stones resistant to SWL. In this review, we aimed to explore the treatment approaches for patients with lower pole renal stone in the light of the current literature.