RENAL PARENCHYMAL INJURY AFTER STANDARD AND MINI PERCUTANEOUS NEPHROSTOLITHOTOMY:

MINIMALLY INVASIVE PERCUTANEOUS NEPHROLITHOTRYPSY IN THE TREATMENT OF PATIENTS WITH KIDNEY STONES

OBJECTIVE

The aim: To evaluate the outcomes and complications rate of minipercutaneous nephrolithotripsy (MPCNL) for renal stones treatment.

PATIENTS AND METHODS

Materials and methods: MPCNL was performed to 123 patients with kidney stones from January 2020 till November 2021. All operations were performed under endotracheal inhalation anesthesia. After the ureteral catheter was introduced ultrasound controlled punction of kidney collecting system and work channel dilation were performed. Stones were fragmented by holmium laser. The fragments extracted passively with fluid flow through the outer sheath. Operation ended by introduction of nephrostomy tube 14Ch.

RESULTS

Results: In total 135 MPCNLs were performed in 123 patients. The average duration of operations was 55±5,4 minutes and stone size was 1,6±0,2 sm. 12 patients were per¬formed simultaneous MPCNL on both sides. The simultaneous MPCNL duration amounted 105±8,1 min. In 3 (2,2%) cases residual stones were observed. The average hospital stay was 1,31±0,2 days. The renal drainage was removed in 24 ± 3,2 hours after operation. Acute pyelonephritis was presented in 4 (3,3%) and postoperative bleeding in 2 (1,6%) patients, which were stopped by antibacterial and hemostatic drugs with drainage occlusion respectively.

CONCLUSION

Conclusions: To advantages of MPCNL belong short hospital stay, high safety level, insignificant intraoperative and postoperative bleeding, good operation field visualization, opportunity of quick removal of renal drainage, ureteral and urethral catheters. Benefit in patients with severe comorbidities, opportunity of simultaneous bilateral MPCNL and almost complete postoperative pain absence allow to consider MPCNL the operation of choice in kidney stone management.

Pitfalls in the management of patients with primary hyperoxaluria: a urologist’s perspective

The primary hyperoxalurias are rare, inherited diseases which commonly manifest early in life as urolithiasis. As these patients often present to the urologic surgeon, it is imperative that urologists understand the typical presentation, diagnosis, and management of urolithiasis associated with primary hyperoxaluria. In this review, the pertinent epidemiology and pathogenesis as they relate to the diagnosis and natural history of the disease are discussed. The literature on therapeutic options for primary hyperoxaluric patients with calculi is examined, and treatment strategies are suggested.