Percutaneous imaging-guided access for the treatment of calculi in continent urinary reservoirs.
OBJECTIVE
To describe our long-term experience with percutaneous access to continent urinary reservoirs for calculus removal.


METHODS
A retrospective study of 13 procedures in 10 patients was performed. In 2 of the 13 procedures, access and calculus removal was performed in a single session. In the other 11 procedures, initial access was obtained using ultrasonography, fluoroscopy, and/or computed tomography. The patients then returned at a later date for a second step where the access was dilated and the calculi were removed.


RESULTS
Access was achieved successfully in all cases with no complications. At mean follow-up time of 13.6 months (range 1-94 months) one patient had died of complications unrelated to her continent urinary reservoir. Another patient had been placed on suppressive antibiotics for recurrent calculi. The remaining patients were stone free and without late complication.


CONCLUSIONS
Percutaneous removal of reservoir calculi can be performed safely, avoiding potential injury to the continence valve mechanism by a direct cystoscopic approach. We propose a two-stage procedure using CT guidance for initial access as the preferred technique.
Davis
Winston Brooks
WB
Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana 46202-5253, USA.
Trerotola
Scott O
SO
Johnson
Matthew S
MS
Patel
Nilesh H
NH
Namyslowski
Jan
J
Stecker
Michael S
MS
McLennan
Gordon
G
Shah
Himanshu
H
Bihrle
Richard
R
Foster
Richard
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000000981:diagnostic imaging / Q000628:therapy*; D016476:Urinary Reservoirs, Continent