Abdulkadir Tepeler1, Priyanka D Sehgal2, Tolga Akman3, Ali Unsal4, Ekrem Ozyuvali4, Abdullah Armagan3, Stephen Y Nakada2. 1. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address: tepeler@urology.wisc.edu. 2. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI. 3. Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul Turkey. 4. Department of Urology, Kecioren Teaching and Research Hospital, Ankara, Turkey.
Abstract
OBJECTIVE: To analyze the patient- and procedure-related factors affecting the outcomes of percutaneous nephrolithotomy (PNL) in horseshoe kidneys (HSKs). METHODS: A retrospective analysis was done of patients with stones in HSKs treated with PNL in 3 referral centers between 1998 and 2013. Demographics, along with perioperative characteristics, were evaluated in detail as to whether or not they had an effect on the success and complication rates. RESULTS: A total of 54 HSKs with calculi in 53 patients were treated with PNL. Mean stone size was 28.4 ± 19.6 mm (range, 10-120 mm). Fifty-three patients were treated through a single tract, and 1 patient required additional access. Access was directed to the upper calyx (n = 27), middle calyx (n = 17), and lower calyx (n = 10) through the intercostal (n = 23) and subcostal (n = 31) areas. Flexible nephroscopy was used in 18.5% of the procedures. Postoperative complications were observed in 9 (16.7%) of the procedures. Success rate was 66.7% after a single session of PNL and increased to 90.7% with additional treatments. Although patient demographics, preoperative imaging, and other operative measures did not have significant effect on the complication rate, stone complexity and multiplicity, in combination with flexible nephroscopy, were found to significantly affect the success rate (P = .026, P = .043, and P = .021, respectively). However, in multivariate analysis stone multiplicity was the only factor that affected success rate (P = .004). CONCLUSION: Stone parameters play an important role in achieving stone-free status in HSKs. Use of flexible nephroscopy positively affects the success rate by allowing reaching the peripherally located calices.
OBJECTIVE: To analyze the patient- and procedure-related factors affecting the outcomes of percutaneous nephrolithotomy (PNL) in horseshoe kidneys (HSKs). METHODS: A retrospective analysis was done of patients with stones in HSKs treated with PNL in 3 referral centers between 1998 and 2013. Demographics, along with perioperative characteristics, were evaluated in detail as to whether or not they had an effect on the success and complication rates. RESULTS: A total of 54 HSKs with calculi in 53 patients were treated with PNL. Mean stone size was 28.4 ± 19.6 mm (range, 10-120 mm). Fifty-three patients were treated through a single tract, and 1 patient required additional access. Access was directed to the upper calyx (n = 27), middle calyx (n = 17), and lower calyx (n = 10) through the intercostal (n = 23) and subcostal (n = 31) areas. Flexible nephroscopy was used in 18.5% of the procedures. Postoperative complications were observed in 9 (16.7%) of the procedures. Success rate was 66.7% after a single session of PNL and increased to 90.7% with additional treatments. Although patient demographics, preoperative imaging, and other operative measures did not have significant effect on the complication rate, stone complexity and multiplicity, in combination with flexible nephroscopy, were found to significantly affect the success rate (P = .026, P = .043, and P = .021, respectively). However, in multivariate analysis stone multiplicity was the only factor that affected success rate (P = .004). CONCLUSION: Stone parameters play an important role in achieving stone-free status in HSKs. Use of flexible nephroscopy positively affects the success rate by allowing reaching the peripherally located calices.
Authors: Ramazan Kocaaslan; Abdulkadir Tepeler; Ibrahim Buldu; Muhammed Tosun; Mehmet Mazhar Utangac; Tolga Karakan; Ekrem Ozyuvali; Namik Kemal Hatipoglu; Ali Unsal; Kemal Sarica Journal: Urolithiasis Date: 2016-07-12 Impact factor: 3.436
Authors: Lisa Lavan; Thomas Herrmann; Christopher Netsch; Benedikt Becker; Bhaskar K Somani Journal: World J Urol Date: 2019-05-17 Impact factor: 4.226
Authors: Abdulhakim Al Otay; Osama Sarhan; Hossam S El-Tholoth; Ahmed Alhelaly; Hamad Al Akrash; Mustafa Al Ghanbar; Khaled Al Bedaiwi; Ziad Nakshabandi; Ali Obeid Journal: Urol Ann Date: 2018 Jul-Sep