Purpose: The management of urolithiasis in patients with a solitary kidney is challenging for endourologists.
This study was aimed at evaluating the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of renal stones in such patients.
Patients and Methods: Between January 2010 and January 2014, we enrolled 45 patients who had a solitary kidney and underwent RIRS and holmium: yttrium-aluminum-garnet lithotripsy for the management of renal stones. We collected data pertaining to the preoperative patient characteristics, stone dimensions, and postoperative outcomes.
Results: Sixty-eight procedures were performed in all. The mean stone diameter was 1.84±0.19 cm (range: 0.5-6.0 cm), and the mean operative time, 76.4±40.14 min (range: 18-190 min). The percentages of patients free of renal stones at the initial and final procedures were 64.44% and 93.33%, respectively. The mean number of procedures required for the patients with renal stones of diameters ≥20 mm and < 20 mm were 1.93 per patient and 1.23 per patient, respectively (p = 0.009). Post-operative complications (graded by the Clavein system) were noted in 26.6% of the patients (12/45): Grade I complications, in 20% (9/45); Grade II complications, in 4.4% (2/45); and Grade III complication, in 2.2% (1/45). The Grade III complication was anuria due to steinstrasse, which necessitated emergent surgery.
Conclusions: RIRS for the removal of renal stones in patients with a solitary kidney affords a high success rate and low morbidity rate. However, for patients with large stones, a multi-staged approach may be required.
Written by:
Gao X, Peng Y, Shi X, Li L, Zhou T, Xu B, Sun Y. Are you the author?
Shanghai Changhai Hospital, Department of Urology, 168 Changhai Road, Shanghai, China.
Reference: J Endourol. 2014 Jun 3. Epub ahead of print.
doi: 10.1089/end.2014.0295
PubMed Abstract
PMID: 24892920
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