Postpercutaneous Nephrolithotomy Ureteropelvic Junction Obstruction

Nerli, Rajendra B; Kadeli, Vishal; Deole, Sushant; Mishra, Aarushi; Patil, Shital; Ghagane, Shridhar C; Hiremath, Murigendra B; Dixit, Neeraj S

doi:10.1089/cren.2019.0084

Cited by 2 publications

(6 citation statements)

References 8 publications

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“…Because complex renal calculi have complex distribution, irregular shape, and large stone diameter, they are easy to cause urinary tract obstruction, infection, and other related complications, causing renal failure, kidney injury, etc., which are a great threat to the life and health of patients [ 10 , 11 ]. Traditional open surgery requires incision of the renal parenchyma, which is easy to cause serious trauma, has a high incidence of postoperative complications, and is easy to residual stones, so the overall effect is difficult to achieve clinical expectations [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Percutaneous Nephrolithotomy Combined with Needle Nephrolithotomy on Renal Function and Complication Rate in Patients with Complex Renal Calculi

Ge¹,

Wang²

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the effect of percutaneous nephrolithotomy combined with needle nephrolithotomy on renal function and incidence of complications in patients with complex renal calculi. Methods. From March 2020 to March 2022, 88 patients with complex renal calculi were enrolled and divided into two groups. Percutaneous nephrolithotomy (PCNL) was performed in the control group, and percutaneous nephrolithotomy combined with needle nephrolithotomy was performed in the study group. Perioperative conditions, renal function parameters such as blood urea nitrogen (BUN), serum creatinine (Scr), and cystatin C (CysC) levels, inflammatory factors such as C-reactive protein (CRP) and procalcitonin (PCT) levels before surgery and 1 day after surgery were determined. The incidence of complications was statistically analyzed between two groups. Results. There was no significant difference in stone clearance rate between the two groups. The operation time and hospital stay in the study group were shorter than those in the control group. The intraoperative blood loss was less than that in the control group. The VAS score was lower than that in the control group. BUN, Scr, and CysC in the study group were not significantly different from those in the control group. CRP and PCT in the two groups at 1 d after surgery were higher than those before surgery, but CRP and PCT in the study group were lower than those in the control group. The incidence of complications in the study group was lower than that in the control group. Conclusion. Percutaneous nephrolithotomy combined with needle nephrolithotomy is effective and safe in the treatment of complex renal calculi.

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Section: Discussionmentioning

confidence: 99%

Effect of Percutaneous Nephrolithotomy Combined with Needle Nephrolithotomy on Renal Function and Complication Rate in Patients with Complex Renal Calculi

Ge¹,

Wang²

2022

Evidence-Based Complementary and Alternative Medicine

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“…Persistent renal collecting system obstruction after PCNL is rare, but may result from stricture, infundibular stenosis, or avulsion which can further lead to hydronephrosis or hydrocalix [ 5 ]. Risk factors for prolonged obstruction after PCNL are longer operative time, large stone burden, and extended postoperative nephrostomy tube drainage [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…PCNL is considered a safe and well-tolerated procedure; however, a specific set of complications are reported such as pain, urinary tract infections, urine leakage, urothorax and pneumothorax, bleeding, and post-procedural ureteropelvic junction (UPJ) obstruction [ 5 , 6 ]. Among these, long-term upper urinary tract obstruction seems to be a rare event, localized at the proximal ureter and UPJ, documented in less than 1% of cases [ 5 ]. Conversely, the most frequently reported reason for transient post-PCNL urinary obstruction is local edema, due to the presence of impacted stones and mechanical trauma that occurred during the procedure and intracorporeal lithotripsy [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among these, long-term upper urinary tract obstruction seems to be a rare event, localized at the proximal ureter and UPJ, documented in less than 1% of cases [ 5 ]. Conversely, the most frequently reported reason for transient post-PCNL urinary obstruction is local edema, due to the presence of impacted stones and mechanical trauma that occurred during the procedure and intracorporeal lithotripsy [ 5 ]. In addition to these factors, concurrent ipsilateral ureteroscopy, stone location, and type of surgical access could also contribute to a transient lack of ureteral canalization after PCNL [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Transient ureteral obstruction after mini-percutaneous nephrolithotomy is associated with stone volume and location: results from a single-center, real-life study

Nizzardo,

Zanetti,

Marmiroli

et al. 2024

World J Urol

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Purpose To evaluate the rate of and predictors of ureteral obstruction after mini-percutaneous nephrolithotomy (mPCNL) for kidney stones. Methods We analyzed data from 263 consecutive patients who underwent mPCNL at a single tertiary referral academic between 01/2016 and 11/2022. Patient’s demographics, stone characteristics, and operative data were collected. A nephrostomy tube was placed as the only exit strategy in each procedure. On postoperative day 2, an antegrade pyelography was performed to assess ureteral canalization. The nephrostomy tube was removed if ureteral canalization was successful. Descriptive statistics and logistic regression models were used to identify factors associated with a lack of ureteral canalization. Results Overall, median (IQR) age and stone volume were 56 (47–65) years and 1.7 (0.8–4.2) cm3, respectively. Of 263, 55 (20.9%) patients showed ureteral obstruction during pyelography. Patients without ureteral canalization had larger stone volume (p < 0.001), longer operative time (p < 0.01), and higher rate of stones in the renal pelvis (p < 0.01) than those with normal pyelography. Length of stay was longer (p < 0.01), and postoperative complications (p = 0.03) were more frequent in patients without ureteral canalization. Multivariable logistic regression analysis revealed that stone volume (OR 1.1, p = 0.02) and stone located in the renal pelvis (OR 2.2, p = 0.04) were independent predictors of transient ureteral obstruction, after accounting for operative time. Conclusion One out of five patients showed transient ureteral obstruction after mPCNL. Patients with a higher stone burden and with stones in the renal pelvis are at higher risk of inadequate ureteral canalization. Internal drainage might be considered in these cases to avoid potential complications.

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Postpercutaneous Nephrolithotomy Ureteropelvic Junction Obstruction

Cited by 2 publications

References 8 publications

Effect of Percutaneous Nephrolithotomy Combined with Needle Nephrolithotomy on Renal Function and Complication Rate in Patients with Complex Renal Calculi

Effect of Percutaneous Nephrolithotomy Combined with Needle Nephrolithotomy on Renal Function and Complication Rate in Patients with Complex Renal Calculi

Transient ureteral obstruction after mini-percutaneous nephrolithotomy is associated with stone volume and location: results from a single-center, real-life study

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