Second Department of Urology, Athens Medical School, Sismanoglio Hospital, Athens, Greece.Department of Urology, Haseki Teaching and Research Hospital, Istanbul, Turkey.
We report a 2-center study of factors affecting the stone-free rate after percutaneous nephrolithotomy in horseshoe kidneys.
The postoperative stone-free rate after percutaneous nephrolithotomy was evaluated in 47 male and 11 female patients with horseshoe kidneys. All data were collected prospectively. Patient and procedure related factors predicting the stone-free rate were analyzed by univariate and multivariate tests.
The mean ± SD stone burden was 7.62 ± 7.18 cm(2) (range 1 to 45) and the stone was larger than 10 cm2 in 14 patients (24.1%). Complex stones and staghorn stones were present in 21 (36.2%) and 19 patients (32.7%), respectively. The overall stone-free rate was 65.5%. Complex stones (p = 0.01), stone burden greater than 5 cm2 (p = 0.013), stone burden greater than 10 cm2 (p = 0.012), multiple stones (p = 0.006) and staghorn stones (p < 0.001) were related to adverse outcomes on univariate analysis. Logistic regression analysis revealed that staghorn calculi was the only factor that significantly predicted the stone-free rate (p = 0.002). A patient with staghorn calculi in the horseshoe kidney was 45 times more likely to have a lower stone-free rate after percutaneous nephrolithotomy than a patient without staghorn calculi in the horseshoe kidney.
Stone parameters are important when treating calculi in horseshoe kidneys. Staghorn calculi are associated with a lower stone-free rate after percutaneous nephrolithotomy.
Skolarikos A, Binbay M, Bisas A, Sari E, Bourdoumis A, Tefekli A, Muslumanoglu AY, Deliveliotis C. Are you the author?
Reference: J Urol. 2011 Nov;186(5):1894-8.