Comparative study on the morphology of renal pelvoclyceal systems of healthy persons and urinary stone formers by excretory urography

Park, Joon Hwan; Seong, In Gi; Han, Bo Hyun

Abstract

Until recently almost exclusively clinicochemical urine parameters have been used to determine the risk of urinary stone formation, because the urinary stone disease is considered as one of metabolic disorders. But the morpholgy of renal pelvocalyceal system also affects on the formation of stone particle and its growth, mainly by establishing urinary stasis. We reviewed 163 excretory urograms retrospectively, and pelvocalyceal systems of healthy persons and urinary stone formers were compared with regard to their morphology. In summary of the study, the majority of pelvocalyceal systems of urinary stone formers showed (1) an increased number of papillae; (2) a greater cranial and caudal exlension of pelvocalyceal sysrem:(3) an increased circular radius of the pelvocalyceal system and hence an increased pelvocalyceal system volume ;(4) an increased pelvic area, especially an enlarged total calyx area and hence a larger total area. (5) a higher degree of ramification and a higher number of branches in the calyx groups ; (6) a more sharp angle between the most caudally situated calyx neck and the direction of pelvic outlet :(7) a highly situated origin or the ureter more frequently ;(8) more frequent ampullary patterns of pelvocalyceal system. But the number of major calyx, the total calyx angle and the angle between the direction of pelvic outlet and the main direction of the ureter showed no statistically significant difference between the urinary stone formers and the healthy persons. The results indicate that the study on the morphology of the renal pelvocalyceal system by excretory urography may be used as a screening test to determine the risk of urinary stone formation.