Flexible ureteroscopy and holmium laser lithotripsy for treatment of upper urinary tract calculi in patients with autosomal dominant polycystic kidney disease.

The objective of the study was to investigate the safety and efficacy of flexible ureteroscopy and holmium laser lithotripsy for the management of patients with autosomal dominant polycystic kidney disease (ADPKD) and associated nephrolithiasis. Between 2005 and 2010, flexible ureteroscopic stone treatment was attempted in 13 patients with ADPKD. Two patients had bilateral renal stones. Most of the stones were located in the renal pelvis and/or calices with a stone size 1.7 cm in the largest diameter. The success rate and morbidity and complications were recorded. A total of 45 intrarenal calculi with a mean stone size of 5.6 mm (range 3-17) were identified. The mean number of stones per patients was 3.2 (range 2-5). The mean number of primary procedures was 1.2 (range 1-2). The overall stone-free rates after one and two procedures were 84.5 and 92.3%, respectively. Complications occurred in three procedures and consisted of low-grade fever in one procedure, flank pain in another procedure and stent pain in another procedure. No patient died. Flexible ureteroscopy with holmium laser lithotripsy is a safe and effective method for the treatment of patients with ADPKD and associated nephrolithiasis.