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Percutaneous nephrolithotomy in anomalous kidney

Author(s)
Naveed Ahmed Mahar Department of Urology, Sindh Institute of Urology and Transplantation,Karachi,Pakistan
Harris Hassan Qureshi Department of Urology, Sindh Institute of Urology and Transplantation,Karachi,Pakistan
Ghullam Mustafa Department of Urology, Sindh Institute of Urology and Transplantation,Karachi,Pakistan
Mohsin Mustafa Memon Department of Urology, Sindh Institute of Urology and Transplantation,Karachi,Pakistan
Sara Rasheed Kalwar Department of Urology, Sindh Institute of Urology and Transplantation,Karachi,Pakistan
Gauhar Sultan Department of Urology, Sindh Institute of Urology and Transplantation,Karachi,Pakistan
Study Design: Cross-sectional study. Department of Urology, Sindh Institute of Urology and Transplantation,Karachi,Pakistan
Abstract
Objective: To assess the stone-free rate (SFR) subsequent to percutaneous nephrolithotomy (PCNL) in patients with anatomically anomalous kidneys. Place and Duration of the Study: Department of Urology, Sindh Institute of Urology and Transplantation Karachi, from 23 July 2020 till 30 October 2021. Methodology: Sixty- ve patients of renal stone disease with abnormal kidneys, aged 18-60 years of both genders were enrolled in this cross-sectional study. Demographic information like age, gender, stone size, duration of disease, and type of abnormality were noted. After PCNL, stone-free status was determined after 2 weeks of the procedure by performing ultrasound KUB. Results: A total of 65 patients were included in this study with mean age of 36.37 ± 12.86 years [Range: 18-60]. There were 76.9% of males and 23.1% of females. Regarding anatomical malformation, 46.2% were malrotated kidneys, 16.9% were horseshoe kidneys, 16.9% were partial Duplex system, 9.2% had bi d pelvis. Median duration of the disease was 12 (IQR=10). Forty-one patients (63.1%) had single and 24 (36.9%) had multiple number of stones with average size of 3.26 ± 1.14 cm. SFR after PCNL in patients with abnormal kidneys was 70.77% (46/65) while 29.23% (19/65) were observed with residual fragments. Out of 19 cases with residual fragments, 10 (53.2%) had stone size <1 cm and 9 (47.4%) had stone of 1 to 3 cm. Sixteen out of 19 patients with residual stones were treated with ESWL (most required: one session), and re-do PCNL was performed in three cases. Conclusion: PCNL is an e ective and safe operation in anatomically anomalous kidneys. For satisfactory outcomes, it requires extreme care and exceptional surgical skill.
Publication Details
Page(s) 1414-1417
DOI 10.29271/jcpsp.2023.12.1414
Published Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 33, Issue: 12, Year: 2023

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Keywords
PCNL, horseshoe kidney, Malrotated kidney, Duplex system, Kidney anomaly, Extracorporeal shockwave lithotripsy (ESWL)
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