Are we performing a lot of simple nephrectomies?

To assess the frequency of simple nephrectomies for benign diseases and compare it with the frequency of nephrectomies for malignant diseases.

The observational study was conducted at the Armed Forces Institute of Urology, Rawalpindi, Pakistan, from October 2008 to September 2011, and comprised patients undergoing simple nephrectomy for benign disease who were followed up for one year. This was compared to all the other urological procedures performed during the study period, including nephrectomies for malignant diseases. Indications and the post-operative sequel of simple nephrectomies were documented. SPSS 16 was used for data analysis.

Of the total 7518 procedures, 1995(26.5%) were open cases. A total of 295 nephrectomies were performed during this period, out of which 203 (68.8%) were simple nephrectomies for benign disease and 92 (31.1%) were radical nephrectomies for malignant causes. Simple nephrectomy (203 cases) represented 2.7% of the total and 26.5% of the open procedures. In contrast, the radical nephrectomies for malignant disease (92 cases) represented 1.2% and 4.6% respectively. Among the 203 cases of simple nephrectomy, the male-to-female ratio was 2.27:1 with 141(69.5%) males and 62(30.5%) females. The mean age was 40.21 + 17.243 years (range: 4-84 years) The most common indication of simple nephrectomy was non-functional kidney due to renal calculus disease 101(49.7%). This was followed by pelvi-ureteric junction obstruction causing renal damage 31(15.2%), chronic pyelonephritis 24(11.2%) and pyonephrosis 15(7.38%). Two (0.98%) patients had a fatal outcome..

The percentage of nephrectomies for benign diseases was more than the malignant diseases. Simple nephrectomies are being performed in a large percentage, indicating the advanced stage of benign diseases at the time of presentation.