Percutaneous nephrolithotomy in patients with urinary tract abnormalities
Philippe D Violette1, Marie Dion, Thomas Tailly
1Department of Surgery, Division of Urology, Schulich School of Medicine & Dentistry, Western University , London, Ontario, Canada .
Journal of Endourology
|October 11, 2014
Summary
Patients with urinary tract abnormalities undergoing percutaneous nephrolithotomy (PCNL) face a higher risk of residual stones and secondary procedures. However, complication rates, operative time, and hospital stay remain comparable to those with normal anatomy.
Area of Science:
- Urology
- Nephrology
- Surgical Outcomes
Background:
- Urinary tract abnormalities increase kidney stone formation risk.
- Percutaneous nephrolithotomy (PCNL) is a key treatment for kidney stones in these patients.
- Outcomes of PCNL in patients with urinary tract abnormalities are less understood than in those with normal anatomy.
Purpose of the Study:
- To assess the impact of urinary tract abnormalities on intraoperative and postoperative outcomes of PCNL.
- To identify predictors of PCNL outcomes in patients with and without urinary tract abnormalities.
Main Methods:
- Prospective single-center database analysis of 2284 PCNL procedures (1935 patients).
- Patients categorized based on presence or absence of urinary tract abnormalities.
- Multivariable analyses to determine predictors of hospital stay, operative time, complications, and residual stones.
Main Results:
- 14.4% of patients had urinary tract abnormalities.
- Patients with abnormalities had higher rates of urinary tract infection but lower rates of hematuria.
- Urinary tract abnormalities predicted residual stones at discharge and need for secondary procedures, but not 3-month residual stones or complications.
Conclusions:
- PCNL in patients with urinary tract abnormalities is associated with increased risk of residual stones at discharge and need for secondary procedures.
- Complication rates, operative time, and hospital stay were comparable between groups.
- Urinary tract abnormalities necessitate careful consideration for residual stone management post-PCNL.
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