Percutaneous nephrolithotomy in pelvic kidneys: is the ultrasound-guided puncture safe?

Urology. 2015 Jan;85(1):55-8. doi: 10.1016/j.urology.2014.08.015. Epub 2014 Nov 6.

Abstract

Objective: To demonstrate our experience with the use of ultrasound (USG) for puncture guidance while performing percutaneous nephrolithotomy in ectopic pelvic kidneys.

Methods: From January 1990 to December 2013, we have performed percutaneous nephrolithotomy in 26 patients with USG-guided punctures. The stones were solitary in 15 patients (58%) and multiple in 11 patients (42%). The mean stone size was 22 mm (range, 10-50 mm), including 3 staghorn calculi. All procedures were performed in an oblique-supine position, and the intraoperative complications as the postoperative outcome were reviewed.

Results: The mean operative time was 93 minutes, achieving complete stone clearance in 22 (88%) of the patients. One of the patients had urine leakage after removing nephrostomy, needing postoperative double J stenting. One patient had significant intraoperative bleeding requiring staging of the procedure and blood transfusion. No bowel injuries were identified. Mean hospitalization time was 5.6 days.

Conclusion: USG-guided puncture is a safe and effective approach to the collecting system even in renal anomalies like in pelvic ectopic kidneys when performed in experienced hands.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Kidney / abnormalities*
  • Kidney / diagnostic imaging
  • Kidney Calculi / complications*
  • Kidney Calculi / diagnostic imaging
  • Kidney Calculi / surgery*
  • Male
  • Middle Aged
  • Nephrostomy, Percutaneous / methods*
  • Punctures / methods*
  • Ultrasonography, Interventional*
  • Young Adult