3 research outputs found
The impact of pelvicaliceal anatomical variation between the stone-bearing and normal contralateral kidney on stone formation in adult patients with lower caliceal stones
OBJECTIVE: We aimed to investigate the effect of pelvicaliceal anatomical differences on the etiology of lower caliceal stones. MATERIALS AND METHODS: Records of adult patients between January 1996 and December 2005 with solitary lower caliceal stone were reviewed. After exclusion of patients with hydronephrosis, major renal anatomic anomalies, non-calcium stones, history of recurrent stone disease and previous renal surgery, 78 patients were enrolled into the study. Lower pole infundibulopelvic angle (IPA), infundibulovertebral angle (IVA), infundibular length (IL), width (IW), number of minor calices and cortical thickness of the lower pole together with other caliceal variables obtained from the whole pelvicaliceal anatomy of both stone-bearing and contralateral normal kidneys were measured from intravenous pyelogram of the patients. Total pelvicaliceal volume was also calculated by a previously described formula for both kidneys. RESULTS: There were statistically significant difference between two kidneys in terms of IW (p < 0.001) and IL (p = 0.002) of the upper calyx, IW (p = 0.001) and IVA (p < 0.001) of the lower calyx), pelvicaliceal volume (p < 0.001), IPA of middle calyx (p = 0.006) and cortical thickness over the lower pole (p < 0.001). However there was no difference between stone-bearing and contralateral normal kidneys in terms of lower pole IPA (p = 0.864) and IL (p = 0.568). CONCLUSION: Pelvicaliceal volume but not lower caliceal properties seem to be a risk factor for stone formation in lower calyx
Factors Affecting the Success Rate of Percutaneous Nephrolithotomy in Paediatric Patients
In this study, we aimed to determine factors affecting the success rate
of percutaneous nephrolithotomy (PNL) in children. The series consisted
of 41 consecutive children operated on by the same surgical team for
renal calculi with PNL between June 2002 and May 2015 in our
institution. A single calyx or pelvic stone was described as simple,
while calculi located in more than one location (calyx and pelvis or
more than one calices) or staghorn stones were described as complex. The
procedure was deemed successful if the patient was completely stone-free
(SF) or had residual fragments <4 mm. Thirty-four patients were found to
be SF or had residual fragments <4 mm on the postoperative first day,
thus the success rate was 82.9\%. In complex stones, the success rate
was significantly lower (45.5\%) than simple stones (96.7\%) (p <
0.001). The grade of hydronephrosis (Grade 0-1 vs. Grade 2-3) also had a
negative impact on the success, with rates of 92.6\% vs. 64.3\%,
respectively (p = 0.022). Previous urological procedure history on the
same side yielded a success rate of 58.3\%, whereas the success rate in
the primary patients was 93.1\% (p < 0.001). The localization of the
stone (complex vs. simple), degree of hydronephrosis, and history of
previous urological procedures were found to be the factors that
affected the success of the paediatric PNL