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POINT-COUNTERPOINT

1.5 cm stone in the lower calyx

flexible ureteroscopy versus percutaneous nephrolithotomy. Introduction

Liatsikos, Evangelosa,b

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doi: 10.1097/MOU.0000000000000631
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Lower pole stones (LPS) are defined as stones located in the inferior pole calyx of the kidney and are the most common renal stones. These stones usually require some kind of active treatment as these are less likely to pass spontaneously [1]. The optimal treatment of LPS with a size of 1–2 cm represents a point of debate among the endourologists. A variety of factors, such as the anatomy of the pelvicalyceal system, patient body habitus, and patient preference may influence the selection of the treatment method [2]. Both percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) have been reported to be effective in the management of these lower pole stones with advantages and disadvantages associated with both the approaches [2–4]. Two well recognized experts, Dr Ghani and Dr Skolarikos will support RIRS and PNL for the management of LPS with a maximal diameter of 1.5 cm, respectively.

Acknowledgements

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Conflicts of interest

There are no conflicts of interest.

REFERENCES

1. Donaldson JF, Lardas M, Scrimgeour D, et al. Systematic review and meta-analysis of the clinical effectiveness of shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy for lower-pole renal stones. Eur Urol 2015; 67:612–616.
2. Skolarikos A, Gross AJ, Krebs A, et al. Outcomes of flexible ureterorenoscopy for solitary renal stones in the CROES URS Global Study. J Urol 2015; 194:137–143.
3. Knoll T, Jessen JP, Honeck P, Wendt-Nordahl G. Flexible ureterorenoscopy versus miniaturized PNL for solitary renal calculi of 10-30 mm size. World J Urol 2011; 29:755–759.
4. Turk C, Petrik A, Sarica K, et al. EAU Guidelines on interventional treatment for urolithiasis. Eur Urol 2016; 69:475–482.
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