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Narendra Wankhade
Atul Khalkar
Suhas Ghule Ghule
Hemant Naik


Background: Impacted PUJ calculi are well known entity.  Nephrolithiasis is a common disorder that accounts for significant cost, morbidity, and loss of work. Over last 3 decades considerable advances have been made in the management of kidney stone disease, still there is no single universally accepted and uniformly effective modality of treatment in medium size of impacted PUJ calculi. Aim: To study the efficacy of lithotripsy and MINIPERC in 11mm to 18mm impacted PUJ calculi. Methodology: The patients with impacted PUJ calculi of size 11 to 18mm of both sexes of all age group varying form 18-60 years, on consecutive sampling method total 84 patients were included. All patients underwent basic lab investigations, USG, IVU and investigations for fitness purpose. Group 1: All procedures were tubeless.  We used 15 Fr Richard Wolf nephroscope for the procedure. 16 to 20 Fr Amplatz sheath was used depending upon situation. Fragmentation was performed using pneumatic lithoclast or holmium Laser depending upon stone size and characteristics. Group 2: Underwent DJ stenting under subarachnoid block or short GA depending upon situation. On the next day they were subjected for lithotripsy on Dorniel alpha machine under USG guidance, 3000 shocks were given in each sitting. One to three such sittings were given. Post operatively ultrasonography and X-ray KUB was done in all the patients and stents were removed after assuring complete clearance. Patients with absence of stone or presence of stone less than 4 mm on USG or x-ray KUB were declared as completely cleared. Results: Average hospital stay was 48 hours in miniperc group and it was 30 hours in DJ with ESWL group. Clearance rate was 100 % in Miniperc group and it was 85.71 % in DJ with ESWL group. Five patients (11.9%) in DJ lithotripsy group required another procedure. (Two needed miniperc and three needed URS). Two(4.76 %) patients in miniperc group had fever in post op period but nobody suffered major sepsis. Conclusion: Miniperc fulfils many criteria if we see results and complications. Although bigger sized multicentric study and long term follow up is needed. 

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Wankhade, N., Khalkar, A., Ghule, S. G., & Naik, H. (2018). COMPARATIVE STUDY OF LITHOTRIPSY AND MINIPERC IN 11 TO 18 MM IMPACTED PUJ CALCULI. International Journal of Clinical and Biomedical Research, 4(3), 30-34.
Original Research Articles


1. Sangtate Park, Margaret SP. Pathophysiology and management of calcium stones. Urol, Clin N Am. 2007;34:323-334.
2. Ravindra B. Sabnis, JitendraJagtap, Shashikant Mishra, Mahesh Desai. Treating renal calculi1–2 cm in diameter with minipercutaneous or retrograde intrarenal surgery: a prospective comparative study BJU International. 2011;108(7):160.
3. Nicole LM, Andrews PE, James EL. Pathogenesis of renal calculi. Urol, Clin N Am. 2007;34:295-313.
4. Paramjit SC. Evaluation of the recent stone former. Urol, Clin N Am. 2007;34:315-322.
5. Naeem Bhojani, James EL. Shockwave lithotripsy- New concepts and optimizing treatment parameters. Urol Clin N Am. 2013;40:59-66.
6. AbdulkadirTepeler, Abdullah Armagan, Ahmet Ali Sancaktutar. Role of microperc in the treatment of symotomatic LPC calculi. J.endourology. 2013;27(1):10
7. Rajiv Goel, Monish Aron, Pawan K. Kesarwani. Percutaneous Antegrade Removal of Impacted Upper-Ureteral Calculi: Still the Treatment of Choice in Developing Countries. Journal of Endourology. 2005;19(1):54-57
8. Mohammed S. Al-Marhoon,Omar Shareef, Ismail S. Al-Habs. Extracorporeal Shock-wave Lithotripsy Success Rate and Complications: Initial Experience at Sultan Qaboos University Hospital Oman Med J. 2013;28(4): 255–259.
9. Sven Lahmea, Karl-Horst Bichler , Walter Ludwig Strohmaier , Tobias Gotz. Minimally Invasive PCNL in Patients with Renal Pelvic and Calyceal Stones. Eur Urol. 2001;40:619–624
10. Berkan Resorlu, Cengiz Kara and Ali Unsal. Prospective comparative study of miniperc and standard pnl for treatment of 1 to 2 cm size renal stone. BJU International. 2011;108(7):160
11. Omar M. Aboumarzouk, ManojMonga, Slawomir G. Kata.Flexible Ureteroscopy and Laser Lithotripsy for Stones >2 cm: A Systematic Review and Meta-Analysis. Journal of Endourology. 2012, 26(10): 1257-1263
12. Nikolaos Ferakis and Marios Stavropoulos.Mini percutaneous nephrolithotomy in the treatment of renal and upper ureteral stones: Lessons learned from a review of the literatureUrol Ann. 2015 7(2): 141–148.
13. Aneeshshivastva and SaurabhChipale. Management of 1-2 cm renal stones. Indian J Urol. 2013; 29(3): 195–199.
14. Kamal Moufid, Najib Abbaka, Driss Touiti. Large impacted upper ureteral calculi: A comparative study between retrograde ureterolithotripsy and percutaneous antegradeureterolithotripsy in the modified lateral position. Urology annals. 2013;5(3):140-146.