Percutaneous Nephrolithotomy: Primary Patients versus Patients with History of Open Renal Surgery

Abstract

Symptomatic presentation of a completely duplicated collecting system with upper-pole ectopic ureteral insertion is rare in the adult. We present a case of a 52-year-old man with recurrent prostatitis and hematuria secondary to an ectopic ureteral insertion from a left upper-pole moiety in a completely duplicated collecting system. He underwent a robot-assisted laparoscopic ureteropyelostomy with good results. We describe our technique in this unusual case.

Factors affecting stone free rate of primary percutaneous nephrolithotomy on staghorn calculi: a single center experience of 15 years

“…This is different from the previous study conducted by Kurtulus et al 28 that compared patients who undergone PCNL for the first time with patients who had previous history of open renal stone surgery. In patients who have a history of open renal stone surgery, infundibulum stenosis, perinephric fibrosis, bowel displacement, and incisional hernia are the major factors that should be taken into account by the surgeon 29, 30 .…”

“…As long as the safety rules are strictly followed, PCNL can still be performed with minimal complication and high success rates despite the technical and access difficulties encountered in secondary or tertiary cases due to anatomic positional differences of the kidney and fibrosis as mentioned by Kurtulus et al . 28 . In their study, the residual stone rate wasn’t significantly different between patients who had previous history of ipsilateral open renal stone surgery and patients who undergone PCNL for the first time (5% vs 3%, p>0.05).…”

“…Kurtulus et al had difficulty in dilating percutaneous tract in patients with history of ipsilateral open renal stone surgery. With the help of newly developed high-pressure balloons, assistance of fascial dilators, or by mechanical dilators, difficulty in establishing access may be overcomed 28 . In some other studies, it had been reported that open stone surgery can increase PCNL failure rate 31 , while others showed that previous open stone surgery does not affect PCNL outcome 32– 34 .…”

PCNL - a comparative study in nonoperated and in previously operated (open nephrolithotomy/pyelolithotomy) patients - a single-surgeon experience

“…At the outset (i.e at the time of puncture and dilation) perirenal fibrosis and retroperitoneal scarring, may cause a problem (8)(9)(10). This was depicted in our study too, as we had to make more attempts to access the PCS in previously-operated patients compared to primary cases.…”

“…Some have recommended a preoperative CT scan so as to study the relationship between the adjoining viscera to the kidney following open surgery (8,10). However, this view is not shared by others (14,15).…”