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Percutaneous nephrolithotripsy: a functional and morphological study.

D R Webb, J M Fitzpatrick

    The Journal of Urology
    |September 1, 1985
    PubMed
    Summary
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    Percutaneous nephrolithotomy, including nephrostomy track creation and lithotripsy, causes minor initial renal anatomical defects. These defects rapidly resolve within six weeks without impacting overall renal function.

    Area of Science:

    • Nephrology
    • Urology
    • Surgical Anatomy

    Background:

    • Percutaneous removal of kidney stones (renal calculi) necessitates creating a nephrostomy track, irrigation, and lithotripsy.
    • Understanding the impact of these procedures on kidney function and anatomy is crucial for patient safety and outcomes.

    Purpose of the Study:

    • To investigate the effects of percutaneous nephrostomy, irrigation, and lithotripsy on renal function and anatomy.
    • To assess the short-term (48 hours) and medium-term (6 weeks) consequences of these interventions.

    Main Methods:

    • Renal access was established in dogs via a subcostal incision and a 22 Ch nephrostomy track with serial dilation.
    • Kidney stones were placed in the renal pelvis and disintegrated using ultrasonic or electrohydraulic probes.

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  • Renal function was evaluated using creatinine clearance; anatomy was assessed via microfil casts, radiography, and angiography.

    • Main Results:

    • No significant urinary leakage or bleeding was observed post-procedure.
    • Minor track hematomas and parenchymal scars were noted at 48 hours, resolving to fine scars by 6 weeks.
    • No ureteric or pelvic damage occurred; renal function (creatinine clearance) remained unchanged.

    Conclusions:

    • Transparenchymal nephrostomy, irrigation, and nephrolithotripsy result in transient, minor anatomical defects.
    • These procedural effects resolve quickly and do not lead to any measurable loss of renal function.
    • The study supports the safety profile of percutaneous renal stone removal techniques.