Introduction and Objectives
The treatment of the lithiasis developed on solitary kidney (congenital, surgical or functional) can be difficult, especially by the important postoperative complications (hemorrhage or infections), which can put in danger the patients’ life. For the stones >15mm in diameter, the PNL represent the main treatment method.
Material and Methods
Between January 1999 and June 2008, 143 patients with urolithiasys developed on unique kidney were treated using PNL. The stones dimensions were between 15 and 70 mm. At all the patients the punction was fluoroscopic and the fragmentation was ballistic and using ultrasound (sonotrod).
The general stone-free rate was 90.2%; 91 patients needed one PNL session. At 20 patients (all with stones >30 mm), 2 or more PNL sessions were necessary. At 28 patients, the treatment was completed using ESWL. The complications rate was 9.8 %, the 2 most important were bleeding and infections. No patient needed surgical treatment for hemorrhage. All the patients were checked at every 6 months (ultrasound examination and blood and urine samples). 24 patients developed new calculi, these being solved by PNL 10 and ESWL (with JJ stent) 14.
PNL represents, according to our experience the most efficient treatment method for calculi >15 mm. The lithiasis developed on unique kidney needs supplementary peri- and postoperative precautions and the postoperative evaluations must be very rigorous in order to prevent recidives.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.