Aim
This study aims to evaluate the results of patients we treated with nephrectomy due to Xanthogranulomatous pyelonephritis (XGP) and the effects of kidney volume on the results.
Patients and methods
Records of 22 patients who underwent nephrectomy due to renal masses at our clinic between January 2008 and May 2018 and whose pathology results indicated XGP were retrospectively evaluated. The computed tomography (CT) measurement of the kidney volumes of the patients was calculated as the product of the longest length, width, and height of the kidney. The mean kidney volume of the patients was calculated and the patients were distributed into two groups: those that presented volumes below average (Group 1) and above average (Group 2). The patients’ mean ages, operative duration, hospitalization days, differences in pre- and postoperative hemoglobin and creatinine levels, and postoperative complications were compared across groups.
Results
Group 1 consisted of 12 patients and Group 2 of 10 patients. The mean kidney volume of the patients was calculated as 33.4 cm
3
± 26.0 cm
3
. The mean kidney volume of the patients was 15.8 cm
3
± 9.9 cm
3
in Group 1 and 56.8 cm
3
± 21.8 cm
3
in Group 2. There were no statistical differences between the two groups in terms of operative times, preop-postop hemoglobin (Hgb) levels and complications.
Conclusion
In cases where XGP is considered probable, the priority in preoperative CT must be to thoroughly evaluate the relationship of the kidney with the surrounding tissue and organs rather than to investigate the patients’ kidney volumes.
ÖZThe ureters are rarely exposed to trauma. Ureteral injuries are generally in the form of iatrogenic, blunt injuries, and rarely penetrating injuries. Iatrogenic injuries often occur during surgical procedures. They do not present with specific findings and symptoms, therefore, they have lateonset symptoms. Imaging modalities of choice are usually intravenous pyelography and computed tomography. Treatment is tailored to the location of the trauma.
ObjectiveTo evaluate the effects of previous unsuccessful extracorporeal shockwave lithotripsy (ESWL) treatment on the performance and outcome of percutaneous nephrolithotomy (PCNL).Patients and methodsOf 1625 PCNL procedures performed in our clinic, 393 renal units with similar stone burden and number of accesses was included in the present study. We categorised the study patients into two groups according to whether they underwent ESWL within 1 year prior to PCNL or not. Accordingly, Group 1 comprised 143 (36.3%) ESWL-treated patients and Group 2 comprised 250 (63.7%) non-ESWL-treated patients.ResultsResidual stones were detected in 36 (25.1%) of the ESWL-treated patients (Group 1) and in 60 (24%) of non-ESWL-treated patients (Group 2). There were no statistically significant differences between the groups for length of hospital stay (LOS), nephrostomy tube removal time, and the presence of residual stones. When we evaluated the groups for both the preoperative and postoperative haemoglobin (Hb) drop and blood transfusion rate, manifest Hb declines and more transfusions were required in the ESWL-treated patients (both P = 0.01).ConclusionsIn our study, previous ESWL treatment had no influence on the PCNL stone-free rate, operation time, incidence of postoperative complications, and LOS, in patients with similar stone burdens. However, bleeding during PCNL was more prevalent in the ESWL-treated patients, so close attention should be paid to bleeding in patients who have been pretreated with ESWL.
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