Reply by the Authors

Abstract

We deeply appreciate the authors' inquiries about our report, and we believe that our answers will provide more details about the topic of insignificant residual fragments after percutaneous nephrolithotomy. We do agree that residual fragments that remain after stone disintegration could have different behavior than that of the originally left peripheral caliceal stones. In our report, 1 Osman Y. Harraz A.M. El-Nahas A.R. et al. Clinically insignificant residual fragments: an acceptable term in the computed tomography era?. Urology. 2013; 81: 723-726 Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar 14 of 25 residual stones (56%) remained after the primary percutaneous nephrolithotomy session, demonstrated growth, and required adjuvant intervention. Therefore, it is difficult to draw solid conclusions of whether primary fragmented stones or left stones could have an effect on the growth of residual stones. We showed that the median stone size had significantly increased from 5 mm (interquartile range 1) to 20 mm (interquartile range 14) during the follow-up period (P < .001). Although this information is crucial to determine the rate of residual fragment growth, it must be calculated prospectively to accurately detect the interval to a significant increase in size. Re: Osman et al.: Clinically Insignificant Residual Fragments: An Acceptable Term in the Computed Tomography Era (Urology 2013;81:723-726)UrologyVol. 82Issue 2PreviewWe congratulate the authors for demonstrating that small residual fragments ≤5 mm after percutaneous nephrolithotomy (PCNL) can be expected to require active intervention in one third of patients at intermediate follow-up and that single residual fragments ≤3 mm can be considered clinically insignificant. We have a few queries. Full-Text PDF