Effects of severe hydronephrosis on the outcomes of percutaneous nephrolithotomy with one-shot dilation method

Abstract

Objective: To investigate the effect of the presence of severe hydronephrosis on percutaneous nephrolithotomy (PNL) outcome in patients who underwent PNL operation with one-shot dilatation technique. Materials and methods: Medical data of 989 patients underwent PNL operation in our clinic between 2012 and 2018 were retrospectively reviewed. We included 373 of the patients underwent PNL operation due to renal pelvic stone, who were older than 18 years of age, who did not have any urinary tract abnormality, and had no previous history of open renal stone operation. Patients were divided into two groups according to the presence of severe hydronephrosis and absence of hydronephrosis. These two groups were compared in terms of age, gender, body mass index (BMI), number of stones, stone burden, operation duration, fluoroscopy time, hospitalization time, hemoglobin and creatinine change, complications, and stone free rate. Results: There was no statistically significant difference between the groups in terms of age, gender, BMI, stone number, stone size, stone density, operation duration, fluoroscopy time, and hospitalization duration. The mean change in hemoglobin was 1.5 g/dL in group 1 and 1.1 g/dL in group 2. This difference was statistically significant ( p = 0.006). Postoperative blood transfusion was required for 3 patients (2.1%) in group 1 and 12 patients (5.1%) in group 2. This difference was statistically significant ( p < 0.001). Conclusion: Only the presence of severe hydronephrosis was found to be associated with the change in hemoglobin and postoperative blood transfusion.

Prevalence of acute kidney injury following percutaneous nephrolithotomy

“…The edematous renal parenchyma can reduce the number of PCNL puncture trials due to the wider calyceal mouth and the more evident distribution of the contrast material. This could result in decreased punctural damage and lower operative duration,[ 24 ] lowering the rate of AKI occurrence.…”

Effects of severe hydronephrosis on surgical outcomes of minimally invasive percutaneous nephrolithotomy (MPCNL).

“…Micoogullari et al reported that the operation duration was shorter in the hydronephrosis group as compared to the cohort without hydronephrosis (although this difference was not statistically significant). Due to the wider caliceal mouth to be accessed and more evident distribution of opaque material in the pelvis, they mentioned that the presence of hydronephrosis may facilitate calyx access by reducing the attempts of renal puncture trials and thusly decreased the operative time [14]. Karatag et al compared the results of MPCNL with and without hydronephrosis.…”