Percutaneous nephrolithotomy in patients with a solitary kidney

  • Tufan Süelözgen Tepecik Training and Research Hospital, Urology Clinic, Izmir, Turkey.
  • Salih Budak | salihbudak1977@gmail.com Tepecik Training and Research Hospital, Urology Clinic, Izmir, Turkey.
  • Orcun Celik Tepecik Training and Research Hospital, Urology Clinic, Izmir, Turkey.
  • Okan Yalbuzdag Tepecik Training and Research Hospital, Urology Clinic, Izmir, Turkey.
  • Oguz Mertoglu Tepecik Training and Research Hospital, Urology Clinic, Izmir, Turkey.
  • Selcuk Isoglu Tepecik Training and Research Hospital, Urology Clinic, Izmir, Turkey.
  • Mehmet Yoldas Tepecik Training and Research Hospital, Urology Clinic, Izmir, Turkey.
  • Yusuf Ozlem Ilbey Tepecik Training and Research Hospital, Urology Clinic, Izmir, Turkey.

Abstract

Material and method: The results of percutaneous nephrolithotomy applied to 716 patients in our clinic between January 2008 and January 2014 were retrospectively evaluated. Age, gender, urinary calculi size (mm2), urinary calculi localization, ESWL history, operation duration (min), fluoroscopy duration (sec), access type, reason of solitary kidney, hemoglobin drawdown (g/dl) and operation success of the patients with a solitary kidney were recorded. The patients having no preoperative and postoperative non contrast abdominal tomography were excluded from the study. Results: Fifteen of nineteen patients (79%) were men and 4 of them (21%) were women. The average age of the patients was 42.52 ± 16.72 (14-72). Ten patients had anatomical solitary kidney and nine patients had physiological solitary kidney. In fact counter kidney was non functional in 9 patients (47%) whereas there was agenesis in 2 (11%) and outcome of nephrectomy in 8 (42%) patients. In our study, presence of residual stone less than 4 mm at 1st month postoperative non contrast abdominal tomography was accepted as a successful result and accordingly our success rate was detected as 84%. Mean urinary calculi size was 405 ± 252.9 mm2; urinary calculi localization was pelvic, lower pole, upper-middle pole, middle-lower pole and staghorn in 11 (58%), 4 (21%), 1 (5%), 1 (5%) and 1 (5%) patients, respectively; previous ESWL history was 16%; operation duration was 55.47-± 28.1 min and fluoroscopy duration 131.10 ± 87.6 sec; access type was subcostal in 79%, supracostal in 10.5% and multiple in 10.5%; hemoglobin drawdown was 1.75 ± 0.97 mg/dl. Conclusions: PNL can be effectively and safely administered for the treatment of solitary kidney. In the treatment of large urinary calculi in patients with a solitary kidney, PNL has some advantages such as short surgery duration, less complication, acceptable hemoglobin drawdown and high success rates. According to our study, PNL operation in patients with a solitary kidney is a good option for carefully and poisedly selected cases.

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Published
2014-12-30
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Issue
Section
Original Papers - Stones and Infections
Keywords:
Percutaneous nephrolithotomy, Solitary kidney, Urinary calculi
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How to Cite
Süelözgen, T., Budak, S., Celik, O., Yalbuzdag, O., Mertoglu, O., Isoglu, S., Yoldas, M., & Ilbey, Y. (2014). Percutaneous nephrolithotomy in patients with a solitary kidney. Archivio Italiano Di Urologia E Andrologia, 86(4), 253-256. https://doi.org/10.4081/aiua.2014.4.253