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Purpose: Percutaneous nephrolithotomy is standard therapy for upper tract calculi larger than 2 cm. However, the role of percutaneous nephrolithotomy in patients with autosomal dominant polycystic kidney disease has not been well evaluated. We report our experience with percutaneous nephrolithotomy in patients with autosomal dominant polycystic kidney disease.
Materials And Methods: We retrospectively reviewed the charts of all patients with autosomal dominant polycystic kidney disease and subsequent renal calculi managed by percutaneous nephrolithotomy from October 1981 to the present.
Results: We identified 9 patients. Percutaneous nephrolithotomy was performed in 11 kidneys. Flank pain was the presenting symptom in 6 patients. Average stone burden was 2.5 cm (range 1.6 to 3.6). Two access tracts were necessary in 5 kidneys. No intraoperative complications occurred. In 2 kidneys a second stage endoscopic procedure with ultrasonic lithotripsy was required to achieve stone-free status. Nephrostogram 24 hours after the final procedure showed no residual stone fragments in 9 of 11 kidneys (82%). The remaining 2 patients underwent percutaneous basket extraction to render them stone-free. There were no postoperative complications or recurrent stones. No patient required blood transfusion. Mean followup was 2.7 years (range 0.3 to 4). Mean calculated creatinine clearance was stable at 85.6 (range 45.9 to 126.6) and 89.5 mg/dl per minute (range 39.6 to 126.6) preoperatively and at last followup, respectively (p = 0.783).
Conclusions: Autosomal dominant polycystic kidney disease increased operative complexity, the need for multiple percutaneous access tracts and the likelihood of repeat endoscopy. Despite the altered anatomy percutaneous nephrolithotomy was a safe, efficacious approach for autosomal dominant polycystic kidney disease. At last followup there was no stone recurrence and renal function was stable.
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http://dx.doi.org/10.1016/j.juro.2009.08.141 | DOI Listing |
J Endourol
December 2024
Department of Urology, University of California San Francisco, San Francisco, California, USA.
To develop and validate a high-fidelity, nonbiohazardous simulator model for the ultrasound-guided percutaneous nephrolithotomy procedure. We employed a systematic framework based on Delphi consensus and modern education theory to design a simulation model. Twelve expert surgeons provided input through a hierarchal task analysis and identified procedural tasks, anatomical landmarks, and potential errors.
View Article and Find Full Text PDFUrolithiasis
December 2024
Department of Urology, The Second Affiliated Hospital of Nanchang University, No. 461 Bayi Avenue, Donghu District, Nanchang, 330006, Jiangxi Province, China.
Urology
December 2024
Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030. Electronic address:
Objectives: To compare stone-free rates (SFRs), operative times, and transfusion rates of various endoscopic techniques for kidney stone management.
Methods: A systematic review was performed, identifying studies comparing the different endoscopic techniques in patients with renal stones. Studies were grouped by location and size of stones (lower pole, 1-2 cm, and >2 cm).
Urolithiasis
December 2024
Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
The purpose of this study is to address the gap in the existing literature regarding the risk factors for systemic inflammatory response syndrome (SIRS) in patients with a solitary kidney who undergo percutaneous nephrolithotomy (PCNL).This retrospective study reviewed the clinical data of 51 patients with solitary kidney stones who underwent PCNL from January 2018 to January 2024.The study evaluated demographic information, stone characteristics, and laboratory data.
View Article and Find Full Text PDFPurpose: Percutaneous nephrolithotomy (PNL) is a controlled grade IV renal trauma and intraoperative bleeding is the most crucial complication. Contemporarily, pulsed mode thulium laser has been reported to confer adequate hemostasis. Therefore, the primary outcome of this study was to assess safety and efficacy of thulium laser-based hemostasis during PNL.
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