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Updated: Oct 24, 2026
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Published on: July 7, 2026
Simultaneous single-tract percutaneous nephrolithotomy and intrarenal laser marsupialization via
Huy-Hoang Nguyen1,2, Ngoc-Son Do1, Van-Hung Le3
1Department of Urology, VietDuc University Hospital, Hanoi, Vietnam.
Introduction:
Ipsilateral renal stones and simple cysts usually require separate procedures or risk urinary extravasation with cyst-transgressing percutaneous techniques. This pilot study evaluated the safety and feasibility of single-tract percutaneous nephrolithotomy (PCNL) combined with intrarenal holmium:YAG laser marsupialization via a non-cyst-transgressing access.
Material And Methods:
Nine consecutive patients with renal stones (>20 mm) and a solitary Bosniak I cyst underwent single-tract PCNL. A specific non-cyst-transgressing puncture was used. Following stone clearance, the cyst wall was identified via combined endoscopic and ultrasonographic guidance and incised intrarenally to create a ≥1 cm window.
Results:
All procedures were completed with a single tract (median operative time 50 minutes). Stone-free status was achieved in 100% (9/9). Marsupialization succeeded in 8/9 patients; one case with a thick-walled cyst identified intraoperatively was managed by aspiration only. No Clavien-Dindo grade II or higher complications occurred. At 6 months, median cyst diameter decreased by 66% (from 5.6 cm to 1.9 cm), with complete symptom resolution.
Conclusions:
Simultaneous single-tract PCNL and intrarenal marsupialization via non-cyst-transgressing access is a feasible and safe technique. It eliminates the risk of retroperitoneal extravasation inherent to cyst-transgressing approaches. Careful patient selection, particularly regarding cyst wall thickness, is essential.
