Comparison of the outcomes of complete supine percutaneous nephrolithotomy in patients with radiopaque and radiolucent kidney stones

Abstract

Objective: This study compared the stone opacity effect in patients who had radiopaque and radiolucent stones in percutaneous nephrolithotomy (PCNL) results. Material and methods:The medical records of 171 complete supine PCNL procedures were gathered. Patients were categorized into two groups: those with radiopaque (n=141) and those with radiolucent (n=30) stones. Kidney, ureter and bladder x-ray was done a day after PCNL and Ultrasound imaging was done two weeks later to evaluate the stone free rate. A stone free result was defined as having less than 4 mm residual stone size. Outcome parameters were compared by univariate analysis and those which were significantly different between the two groups were assessed by multivariate binary logistic regression analysis.Results: There were no significant differences in age, sex, body mass index, hypertension, diabetes mellitus, pre-surgery hemoglobin, pre-surgery serum creatinine, stone and also surgery-related parameters between the two groups. Stone free rate, surgery time, complication-related parameters, hemoglobin drop, serum creatinine and glomerular filtration rate (GFR) changes were similar in both groups based on univariate analysis. The radiopaque group had higher post-surgery GFR (p= 0.04) and longer hospital stay (p= 0.009). However, opacity had no effect on these outcomes after multivariate analysis. Higher post-surgery GFR was seen in patient with higher GFR before surgery (p<0.0001). Also, higher hemoglobin before surgery was correlated with less hospital stay (p= 0.001). Conclusion:The complete supine percutaneous nephrolithotomy outcomes are similar in patients with radiopaque and radiolucent stones.

Comparison of the Intracorporeal Ultrasonic Lithotripsy and Intracorporeal Pneumatic Lithotripsy in Terms of Stone Removal and Postoperative Complications

“…No stents used in our study at all and pain was managed according to standard treatment strategies and varied from patient to patient. In a study conducted by Falahatkar S et al, 21 fever was observed in 4% of patients only while other signs of infection like dysuria and flank pain observed in 46% and 39 % of patients respectively while in our study, in group A and group B, 2(6.66%) and 3(10%) cases had fever, 3(10%) and 4(13.33%) had infection respectively. On the other hand, in a study conducted by Park K et al, 20 retention of urine was observed in 2.8% of patients while in our study retention of urine was observed in group B patients 3.33 % and in case of group A patients no such complication noted.…”

Ureterolithiasis in Human Immunodeficiency Virus (HIV) Patients Treated with Single-Use Ureteroscope: A Case Report

“…Although the patients in both cases were on long-term oral HIV antiretroviral drugs, the analysis of stone composition was primary stone formation. Some scholars report that the risk of postoperative complications in patients with a CD4+ T lymphocyte count of ≥200 cells/µl is higher than that with patients with a CD4+ T lymphocyte count of <200 cells/µl [ 5 , 6 ]. The CD4+ T lymphocyte count in both of the present patients was ≥200 cells/ µl, and no significant postoperative complications occurred.…”