Korean J Urol.  2013 Oct;54(10):689-692.

Efficacy of Percutaneous Nephrostomy During Flexible Ureteroscopy for Renal Stone Management

• Kwon SY
• Kim BS
• Kim HT
• Park YK

Abstract

PURPOSE
Preoperative percutaneous nephrostomy (PCN) can be applied to urinary stone patients with pyelonephritis as well as obstructive uropathy; thus, some patients undergo flexible ureteroscopy (fURS) in the presence of a PCN tube. We evaluated the effectiveness of PCN during fURS for the management of renal stones.
MATERIALS AND METHODS
We retrospectively analyzed 130 consecutive patients who underwent fURS for renal stones between January 2009 and December 2011. All fURS procedures were performed by a single experienced surgeon. The patients were divided into two groups depending on the presence of PCN during the surgery: patients with PCN (group 1, n=41) and patients without PCN (group 2, n=89). To evaluate operative outcomes, we compared success rates, operative times, and complication rates. We defined success as the absence of any residual stones in the kidney or stone fragments less than 2 mm that were too small to be extracted during follow-up.
RESULTS
There were no significant differences in age, sex, body mass index, stone laterality, burden, or location between the two groups. The mean operative times of groups 1 and 2 were 50.1 and 58.3 minutes, respectively (p=0.102). The success rates of groups 1 and 2 were 95.1% and 82.0%, respectively (p=0.044). There was no statistically significant difference in the complication rate between groups 1 and 2 (p=0.888).
CONCLUSIONS
Flexible ureteroscopy in the presence of PCN produced a superior outcome in terms of the success rate without increasing the operative time or complication rate. PCN may be helpful to induce better outcomes of fURS.

Keyword

Kidney calculi; Percutaneous nephrostomy; Ureteroscopy

MeSH Terms

Body Mass Index
Humans
Kidney
Kidney Calculi
Nephrostomy, Percutaneous
Operative Time
Pregnenolone Carbonitrile
Pyelonephritis
Retrospective Studies
Ureteroscopy
Urinary Calculi
Pregnenolone Carbonitrile

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