kidney calculi

  • Analysis of the Feasibility and Efficacy of Ambulatory/Day Care Percutaneous Nephrolithotomy: An Initial Experience


    Purpose: Tubeless percutaneous nephrolithotomy (PCNL) is a well-accepted procedure for uncomplicated renal calculi. We prospectively evaluated the safety, feasibility, and efficacy of day care/ambulatory PCNL (totally tubeless, discharge within 24 hours) for selected patients for which only few case series have been reported.

    Materials and Methods: Total tubeless PCNL was planned in 40 easily accessible patients with uncomplicated renal calculi, with single infracostal punctures, normal intraoperative events, and acceptable postoperative parameters (visual analogue pain score, parenteral analgesic requirement, bleeding, urinary soakage, hemodynamic stability), allowing an early discharge within 24 hours. Parameters like pain score and analgesic requirement, any complications, and return date to normal work were evaluated at follow-up. Ultrasonography was performed after a week to document stone clearance.

    Results: Mean patient age was 38.6 years (22 to 62), stone size was 21.4 mm (15.4 to 30), and operating time was 72 minutes (42 to 106) without blood transfusion. Regional anesthesia was used in 13 cases while general anesthesia was used in the rest of the patients. Average pain score after 6 hours of surgery was 2.3 (1.8 to 3.6) with vitals in the normal range, and hospital stay was 12.5 hours (5.5 to 23.5). Six patients were excluded due to peri- and postoperative events (2: multiple punctures, 1: hematuria, 1: urine leak, 2: pain). This data was taken with the intention to treat the analysis with a successful application of study protocol in 34 (85%) of preoperatively selected cases. Out of 34 patients that qualified for a complete study protocol, 11 were discharged on the same day of surgery while the rest were discharged the next morning. Postoperative USG confirmed no residual calculus, and all patients had uneventful recoveries. Three patients had minor complications (mild hematuria/urine leaks), which were managed conservatively.

    Conclusion: Our experience with ambulatory PCNL in properly selected cases suggests it as a feasible and effective option that can safely be offered to patients, providing uncomplicated surgery and favorable postoperative parameters.

    Adittya K. Sharma, M. Nagabhushan, G. N. Girish, A. J. Kamath, C. S. Ratkal, G. K. Venkatesh

    Submitted May 20, 2013 - Accepted for Publication June 16, 2013

    KEYWORDS: Percutaneous nephrolithotomy, nephrolithiasis, kidney calculi

    CORRESPONDENCE: Adittya K. Sharma, MCh, Institute of Nephro-Urology, Victoria Hospital Campus, Bangalore, Karnataka, India (, )

    CITATION: UroToday Int J. 2013 August;6(4):art 44. http://dx.doi.org/10.3834/uij.1944-5784.2013.08.03

    Published July 10, 2013
  • Comparative testing of reliability and audit utility of ordinal objective calculus complexity scores. Can we make an informed choice yet?

    To assess reliability of Guy's, Seoul National University renal stone (S-RESC) and S.T.O.N.E. scores in percutaneous nephrolithotomy (PCNL) and assess utility in discriminating outcomes [Stone free rate (SFR), complications, need for multiple PCNL sessions and auxiliary procedures] valid across parameters of experience of surgeon, independence from surgical approach, and variations in institution-specific instrumentation.

    Published August 7, 2016
  • Comparison of intermediate- and low-frequency shock wave lithotripsy for pediatric kidney stones.

    The aim of the study to compare low and intermediate shock wave frequency rates in terms of success and complications for treating pediatric kidney stones. This retrospective study was performed on 58 consecutive pediatric patients (24 girls, 34 boys) who underwent shock wave lithotripsy (SWL) for kidney stones with an electrohydraulic lithotripter between April 2014 and March 2016.

    Published August 4, 2017
  • Differences in the percutaneous nephrolithotomy practice patterns among Latin American urologists with and without endourology training.

    Although the worldwide percutaneous nephrolithotomy (PCNL) practice patterns determined via a survey sent to members of the Endourological Society have been published, differences in PCNL practice patterns among Latin American urologists based on endourological or lithiasis training have not been published.

    Published March 11, 2018
  • Does quality of drinking water matter in kidney stone disease: A study in West Bengal, India.

    The combined interaction of epidemiology, environmental exposure, dietary habits, and genetic factors causes kidney stone disease (KSD), a common public health problem worldwide. Because a high water intake (>3 L daily) is widely recommended by physicians to prevent KSD, the present study evaluated whether the quantity of water that people consume daily is associated with KSD and whether the quality of drinking water has any effect on disease prevalence.

    Published May 13, 2018
  • Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention.

    Phyllanthus niruri (P.niruri) or stone breaker is a plant commonly used to reduce stone risk, however, clinical studies on this issue are lacking.

    To prospectively evaluate the effect of P. niruri on the urinary metabolic parameters of patients with urinary lithiasis.

    Published April 22, 2018
  • Effectiveness of Treatment Modalities on Kidney Stone Recurrence.

    Nephrolithiasis is highly prevalent across all demographic groups in the Western world and beyond, and its incidence rates are rising. In addition to the morbidity of the acute event, stone disease often becomes a lifelong problem that requires preventative therapy to diminish ongoing morbidity.

    Published August 26, 2017
  • Epidemiology and economics of nephrolithiasis.

    Nephrolithiasis is a disease common in both the Western and non-Western world. Several population based studies have demonstrated a rising prevalence and incidence of the disease over the last several decades.

    Published September 5, 2017
  • Feasibility and Safety of Ultrasonography Guidance and Flank Position During Percutaneous Nephrolithotomy.

    Percutaneous nephrolithotomy is generally performed under fluoroscopy that is associated with exposure to radiation. Another drawback of fluoroscopic-guided percutaneous nephrolithotomy is the prone position, which is not suitable for all patients.

    Published March 4, 2018
  • Flexible ureterorenoscopy to treat upper urinary tract stones in children.

    Development of surgical expertise and technology has affected the way renal tract stones are treated. Our hypothesis was that flexible ureteroscopy (FURS) for upper tract stones in children produces good results.

    Published November 11, 2018
  • Green tea intake and risk of incident kidney stones: Prospective cohort studies in middle-aged and elderly Chinese individuals.

    To investigate the association between green tea intake and incident stones in two large prospective cohorts.

    We examined self-reported incident kidney stone risk in the Shanghai Men's Health Study (n = 58 054; baseline age 40-74 years) and the Shanghai Women's Health Study (n = 69 166; baseline age 40-70 years).

    Published November 11, 2018
  • Multiple Sclerosis and Nephrolithiasis: A Matched Case Comparative Study.

    To compare stone composition and serum/urine biochemistries in stone formers with multiple sclerosis (MS) against stone formers without MS and to examine the association between mobility, methods of bladder emptying, and stone formation.

    Published February 26, 2017
  • Nephrolithiasis as a Risk Factor for CKD: The Atherosclerosis Risk in Communities Study.

    Previous studies demonstrated a higher risk of CKD in persons with a history of kidney stones, but these studies examined mostly white populations and did not evaluate important potential interactions such as race and plasma uric acid.

    Published September 21, 2015
  • Outcomes of miniaturized percutaneous nephrolitotomy in infants: single centre experience.

    The present study was aim to evaluate the safety and efficacy of Mini-PNL to treat kidney stones in patients aged <3 years. This is the one of the largest series in the literature in this age group of patients.

    Published July 21, 2017
  • Pathophysiology-based treatment of urolithiasis.

    Urolithiasis, a complex multifactorial disease, results from interactions between environmental and genetic factors. Epidemiological studies have shown the association of urolithiasis with a number of lifestyle-related diseases, including cardiovascular diseases, hypertension, chronic kidney disease, diabetes and metabolic syndrome.

    Published August 22, 2016
  • Prevalence of hypertension and diabetes after exposure to extracorporeal shock-wave lithotripsy in patients with renal calculi: a retrospective non-randomized data analysis.

    To evaluate the association of shock-wave lithotripsy (SWL) for kidney stones and hypertension or diabetes.

    Patients with urolithiasis treated by SWL were retrospectively identified. To assess whether shock-wave application to the kidney is associated with long-term adverse effects, patients after SWL for kidney stones were selected as the main group of interest.

    Published May 28, 2018
  • Prevalence of kidney stones and associated risk factors in the Shunyi District of Beijing.

    Kidney stone formation is a multifactorial condition that involves interaction of environmental and genetic factors. Presence of kidney stones is strongly related to other diseases, which may result in a heavy economic and social burden.

    Published May 8, 2017
  • Quality of life and urolithiasis: the patient - reported outcomes measurement information system (PROMIS).

    With a high rate of recurrence, urolithiasis is a chronic disease that impacts quality of life. The Patient Reported Outcomes Measurement Information System is an NIH validated questionnaire to assess patient quality of life.

    Published August 13, 2017
  • Risk of Hypertension among First-Time Symptomatic Kidney Stone Formers.

    Prior work has suggested a higher risk of hypertension in kidney stone formers but lacked disease validation and adjustment for potential confounders. Certain types of stone formers may also be at higher risk of hypertension.

    Published February 6, 2017
  • Significant differences in struvite and cystine stone frequency seen among Chinese nephrolithiasis patients living in North America compared to those living in China.

    Interracial disparities in nephrolithiasis prevalence have been reported, but the interplay between genetics and the environment for urinary stone disease risk factors is poorly understood. To examine how environment may alter genetic predisposition for stone formation, we established the International Chinese Consortium on Nephrolithiasis (ICCON) as a multi-institutional collaboration to examine patterns of nephrolithiasis presentation between Chinese patients living in different countries.

    Published June 20, 2016
  • The Effect of Glycemic Status on Kidney Stone Disease in Patients with Prediabetes.

    BACKGROUND - While the evidence supporting a positive association between diabetes mellitus and kidney stone disease (KSD) is solid, studies examining the association between impaired fasting glucose (IFG) and KSD show inconsistent results.

    Published May 5, 2016
  • Trends in renal calculus composition and 24-hour urine analyses in patients with neurologically derived musculoskeletal deficiencies.

    To better characterize metabolic stone risk in patients with neurologically derived musculoskeletal deficiencies (NDMD) by determining how patient characteristics relate to renal calculus composition and 24-hour urine parameters.

    Published May 5, 2019
  • Urolithiasis: evaluation, dietary factors, and medical management: an update of the 2014 SIU-ICUD international consultation on stone disease.

    The aim of this review was to provide current best evidence for evaluation, dietary, and medical management of patients with urolithiasis.

    Literature addressing evaluation, dietary, and medical management of urolithiasis was searched.

    Published February 13, 2017

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