Our aim was to evaluate our experience with percutaneous nephrolithotomy (PCNL) in children in the Republic of Yemen. Between January 1993 and December 1998, 135 children underwent 138 percutaneous nephrolithotomies in Yemen. The patient's age ranged between 8 months and 14 years (average 8.9 years). There were 117 boys and 18 girls (male:female ratio 6.5:1). The stone size ranged between 124 and 624 mm2 (average 507 mm2). A 26 F adult nephroscope was used. The stone free rate was 98.5% (136 out of the 138 cases). Two patients had clinically insignificant fragments. A second session had to be performed because of residual stone in one patient. No severe intra- or postoperative complications were observed. We conclude that percutaneous nephrolithotomy is a safe and effective method for the treatment of kidney stones in children. It reduces morbidity and hospital stay and thus the cost of treatment. To our knowledge, this is the largest reported series.

The stone-holding pelvic dystopic kidneys of 15 patients were treated with laparoscopically assisted percutaneous transperitoneal nephrolithotomy. With patients in the Trendelenburg position under laparoscopic control, the bowels were dislodged with forceps until the kidney became visible. Under simultaneous laparoscopic and fluoroscopic control, the nephrostomy track was created on the antegrade route using telescopic metal dilators and a rigid nephroscope. Percutaneous nephrolithotomy was carried out in the usual manner. All the stones could be removed successfully. The only minor complication was a delayed urine leakage through the abdominal drain in a patient with a double J stent. Severe complications did not occur. The average operating time was 55 (40-85) minutes; the average hospital stay was 4.8 (4-11) days. On the basis of the authors' experience and a literature review of cases of failed shock wave lithotripsy-which is quite frequently unsuccessful in these cases-and cases of large, dense stones, this method appears to be the simplest and most suitable minimally invasive treatment of the stone-holding pelvic dystopic kidney.

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Objective To compare simultaneous bilateral percutaneous nephrolithotomy (SBPCNL) and unilateral PCNL in separate sessions in patients with bilateral renal stones for several variables before and after surgery.

On the basis of our experience, laparoscopic ureterolithotomy is a safe and effective method for the treatment of large, dense, and impacted ureteric stones. In selected cases it can be the first choice of treatment.