Clinically Insignificant Residual Fragments (CIRF)
Category: Stones
Definition:
- Size: 4 mm or less, but some times 2 mm
or less
- Non-obstructive
- Non-symptomatic
- Non-infectious (in origin)
- Associated with sterile
urine.
Measures of efficacy:
- Stone free rate: rate of complete clearance of stones
- Success rate: rate of leaving at most CIRF’s.
·
Fate of CIRF? - Dislodge, so to be:
- Obstructive
- Symptomatic
- Source or cause of infection.
·
When to become clinically significant:
- Rate: 43% within 23 mo (~2 years) follow up
- Factors affecting (post ESWL):
§ Lower
pole
§ Multiple
in number
§ Increased
burden by size
§ Longer
duration of follow up
§ Modality
of intervention.
·
Relations:
- Associated with increased
rate of recurrence (6-15% to 17-80%)
- Likelihood to pass is much less in lower pole than in ureter.
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