CU 23. Percutaneous nephrolithotomy in patients with solitary kidney: Report of 12 cases

Objective: To summarize our experiences in applying percutaneous nephrolithotomy (PCNL) for treating patients with a solitary kidney to determine short-term renal functional results.

Methods: We retrospectively reviewed the records of 12 patients with renal staghorn calculi in a solitary kidney treated with PCNL. Ten patients had functional solitary kidneys and 2 patients had anatomic solitary kidney. Demographic data, number of accesses, location of accesses, hemoglobin values, and complications were recorded. Serum creatinine, systolic and diastolic blood pressure, newly onset hypertension, and kidney morphology were determined preoperatively and postoperatively at 1 month and 12 months.

Results: Of these 12 patients, the male to female ratio was 5:1 and the mean age was 46.5 years (range 29-54 years). Ten patients required a single standard tract, while 2 needed a single standard tract and a micro-tract. The complete stone clearance rate was 91.7% (11/12) after the first stage. One patient required extracorporeal shock wave lithotripsy (SWL). A double-J catheter was inserted in all patients and it was removed 4 weeks after operation. No severe complications occurred in all patients and no blood transfusion events took place. A 12-month followup showed that the creatinine level was remarkably improved after the operation. The number of patients with hypertension before PCNL was 3 and by the end of follow-up there was no new-onset hypertension.

Conclusions: PCNL is effective and safe for solitary kidney with staghorn calculi.