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Stones in Exceptional Situations

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Clinical Management of Urolithiasis

Abstract

Calculi in kidneys with complex or anomalous anatomy present unique challenges for the medical as well as surgical aspects of stone treatment. These anomalous conditions include but are not limited to horseshoe, pelvic, ectopic, transplant, and polycystic kidneys. Despite aberrant anatomy, treatments in these situations should follow the same principles applied for treatment for stones in normal kidneys. Medical dissolution therapy should be employed whenever possible, especially because of the increased difficulty of surgical intervention in this patient population. Surgical treatments of stones for these patients include open surgery, extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, percutaneous nephrolithotomy (PCNL), and laparoscopy. This chapter focuses on the efficacy and the rationale behind most recent stone treatments, in the hopes of guiding urologists in formulating a more effective, individualized treatment for this patient population.

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  1. Department of Urology, Columbia University School of Medicine, 161 Fort Washington Avenue, 11th Floor, New York, NY, 10036, USA

    Mantu Gupta M.D. & Doh Yoon Cha M.D.

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  1. Mantu Gupta M.D.
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Correspondence to Mantu Gupta M.D. .

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  1. Klinik für Urologie, Klinikum Sindelfingen-Böblingen, Arthur-Gruber-Str. 70, Sindelfingen, 71065, Baden-Württemberg, Germany

    Thomas Knoll

  2. Center, Department of Urology, UT Southwestern Medical, 5323 Harry Hines, Blvd, Dallas, 75390, Texas, USA

    Margaret S. Pearle

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Gupta, M., Cha, D.Y. (2013). Stones in Exceptional Situations. In: Knoll, T., Pearle, M. (eds) Clinical Management of Urolithiasis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28732-9_16

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