Outcome from percutaneous nephrolithotomy in patients with spinal cord injury, using a single-stage dilator for access.
OBJECTIVE
To present our experience of percutaneous nephrolithotomy (PCNL) for treating urolithiasis in patients with spinal cord injury (SCI) using a single-stage dilator for percutaneous access.


METHODS
A prospective database of patients with SCI having PCNL using the single-stage dilator was assessed, analysing patient data, stone-free rates, morbidity and the follow-up outcome.


RESULTS
In all, 26 patients had 54 PCNLs on 32 kidneys; 20 had unilateral and six bilateral stone disease; there were many staghorn calculi (24/54). Major complications occurred in three of 54 PCNLs (6%). The complete stone-clearance rate was 87% for PCNL alone, rising to 29 of 32 kidneys (91%) or 24 of 26 patients (92%) with adjuvant procedures. A further three kidneys required no further treatment and were monitored, having residual fragments of < or = 2 mm.


CONCLUSIONS
PCNL has a high success rate and acceptable complication rate compared to extracorporeal shock-wave lithotripsy, and remains a valid first-line treatment option for kidney stones in patients with SCI.
Lawrentschuk
Nathan
N
University of Melbourne, Department of Surgery, Austin Hospital, Heidelberg, Victoria, Australia.
Pan
David
D
Grills
Richard
R
Rogerson
John
J
Angus
David
D
Webb
David R
DR
Bolton
Damien M
DM
D004106:Dilatation / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D011782:Quadriplegia / Q000150:complications; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome