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Urinary Tract Calculi VI: Surgical Management

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

Anatomical Positions

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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...

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Related Experiment Video

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Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

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Percutaneous nephrolithotomy: does position matter? - prone, supine and variations.

Ranan DasGupta¹, Anup Patel

¹Imperial College Healthcare NHS Trust, London, UK.

Current Opinion in Urology

|January 30, 2013

Summary

Supine percutaneous nephrolithotomy (PCNL) offers potential benefits but lacks clear overall advantages over the prone technique. Adoption depends on surgeon preference and specific patient factors, with training programs influencing future practice.

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Area of Science:

Urology
Surgical Techniques
Endourology

Background:

Percutaneous renal stone surgery has evolved, with increasing adoption of the supine position alongside the traditional prone technique.
The supine approach offers proposed benefits for anesthesia, patient safety, and surgical ergonomics.

Purpose of the Study:

To review the adoption of supine percutaneous nephrolithotomy (PCNL).
To identify factors influencing the choice between supine and prone PCNL.
To assess the current practice patterns and outcomes of supine PCNL.

Main Methods:

Review of retrospective reports and prospective randomized trials comparing supine and prone PCNL.
Analysis of national and international databases on PCNL practice patterns.
Evaluation of factors influencing surgical position selection.

Main Results:

Limited prospective randomized trials exist, with no clear overall superiority of one position over the other.
Practice patterns are largely surgeon-specific.
Supine PCNL may be preferable in specific cases, such as obese patients.

Conclusions:

Supine PCNL is increasingly offered in specialized centers.
Endourology training programs are incorporating supine PCNL, potentially influencing global practice.
Further research may clarify specific indications and benefits for supine PCNL.