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Does preoperative hydronephrosis affect the stone-free rate of micro-percutaneous nephrolithotomy?

Mustafa Kadihasanoglu1, Erkan Erkan1, Ugur Yucetas1

  • 1Department of Urology. Istanbul Training and Research Hospital. Fatih. Istanbul. Turkey.

Archivos Espanoles De Urologia
|May 10, 2019
PubMed
Abstract

Insights

Preoperative hydronephrosis significantly impacts the success of micropercutaneous nephrolithotomy (microperc), a minimally invasive kidney stone removal technique. The presence of hydronephrosis is associated with lower stone-free rates and increased complications.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrolithiasis Management

Background:

  • Micropercutaneous nephrolithotomy (microperc) is an advanced, minimally invasive surgical technique for kidney stone removal.
  • Understanding factors influencing microperc outcomes is crucial for optimizing patient treatment.
  • Preoperative hydronephrosis, a swelling of the kidney due to urine backup, is a common condition that may affect surgical success.

Purpose of the Study:

  • To investigate the impact of preoperative hydronephrosis on the stone-free rate following micropercutaneous nephrolithotomy.
  • To identify whether the presence or absence of hydronephrosis influences the efficacy and safety of microperc procedures.

Main Methods:

  • A comparative study involving 66 patients undergoing microperc, divided into two groups: those with and without preoperative hydronephrosis.
  • Analysis of demographic data, stone characteristics, operative parameters (including fluoroscopy and operative time), blood loss, stone-free rates, and complication rates.
  • Statistical analysis using univariate and multivariate methods, including logistic regression, to determine factors affecting the stone-free rate.

Main Results:

  • Patients with preoperative hydronephrosis had significantly larger stone burdens compared to those without.
  • While operative time was similar, patients with hydronephrosis experienced higher rates of perioperative and postoperative complications and lower stone-free rates.
  • Logistic regression analysis identified the presence of hydronephrosis as a significant independent predictor of unsuccessful microperc outcomes (OR 0.225, p=0.033).

Conclusions:

  • The presence of preoperative hydronephrosis is a significant negative prognostic factor for achieving a stone-free status after micropercutaneous nephrolithotomy.
  • Hydronephrosis influences not only the success rate but also the complication profile of microperc procedures.
  • Preoperative assessment of hydronephrosis is essential for patient selection and surgical planning in microperc.
Keywords:
HidronefrosisHydronephrosisLitiasis renalMicropercNefrolitotomíaNephrolithotomyRenal stone

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