Ureteropyelocalycostomy in the management of lower calyceal stone.

Side-to-side ureteropyelocalycostomy in 10 patients with lower calyceal calculi uniformly achieved good postoperative kidney drainage and has not been associated with stone recurrence during an average followup of 35.4 months. Five patients have maintained sterile urine postoperatively. Postoperative renal deterioration has been apparent in only 1 patient and it is unrelated to the operative procedure. This approach to the management of a lower calyceal stone has permitted excellent visualization of the collecting system for lithotomy and it has resulted in minimal renal tissue loss. The procedure is particularly appropriate for the management of lower calyceal calculi in kidneys in which there is medial parenchymal thinning over the calyx and preservation of all functioning renal tissue in deemed wise.