Percutaneous nephrolithotomy in patients with or without a history of open nephrolithotomy.
OBJECTIVE
Whether a history of open nephrolithotomy affects the efficacy and morbidity of percutaneous interventions remains unsettled. We investigated this issue in our patients.


METHODS
A series of 51 men and 14 women who had undergone nephrolithotomy at least once (group A; mean age 40 years) were compared with 73 men and 44 women submitting to percutaneous nephrolithotomy (PCNL) as their first surgery (group B; mean age 43 years). All patients were operated on by the same surgeons over the same period of time. Fifty patients (81.5%) in group A harbored a single stone, whereas 35.9% of patients in group B had single stones (P < 0.001). However, the two groups were similar in terms of stone laterality, the right:left ratio being 1.03 in group A and 0.67 in group B (P = 0.22).


RESULTS
The proportion of patients in whom PCNL failed to clear all the stones even though access was obtained did not differ in the two groups (6.15% in group A and 8.55% in group B; P = 0.77). The collecting system was inaccessible in 6.2% and 5.1% of patients, respectively (P = 0.74). Pyelonephritis or abnormal bleeding occurred in similar proportions in the two groups (P = 0.72 and P = 0.74, respectively). No other surgical complications occurred in either group.


CONCLUSIONS
A history of open nephrolithotomy does not adversely affect the efficacy or morbidity of PCNL.
Basiri
Abbas
A
Department of Urology, Labbafi Nejad Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran. abbasbasiri@hotmail.com
Karrami
Hossein
H
Moghaddam
S Mohammadmehdi Hosseini
SM
Shadpour
Pejman
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D011704:Pyelonephritis / Q000209:etiology; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000628:therapy*