Minimally invasive percutaneous nephrolithotomy for upper urinary tract calculi in transplanted kidneys.
OBJECTIVE
To report our experience with minimally invasive percutaneous nephrolithotomy (mPCNL) for upper urinary tract (UUT) calculi in transplanted kidneys.


METHODS
Between August 2002 and June 2006, seven patients (mean age 40.7 years) with UUT stones in transplanted kidneys (including one staghorn, two pelvic and four ureteric stones) were treated by mPCNL. A 16 F peel-away sheath was placed as the percutaneous access port and a 8.5/11.5 F nephroscope or a 8/9.8 F ureteroscope was used for manipulation. Every 2-3 months during the follow-up, patients had their serum urea, creatinine and uric acid measured, with urine culture and ultrasonography.


RESULTS
All patients were rendered stone-free at one mPCNL procedure, with no complications during or after surgery. The mean (range) operative duration was 53 (20-100) min and the mean haemoglobin decrease was 0.55 (0.2-1.2) g/dL. At a mean (range) follow-up of 23 (3-48) months renal allograft function was stable in all patients and no recurrence of stone was detected.


CONCLUSIONS
mPCNL is safe and effective for managing calculi in transplanted kidneys, and it can be the initial therapy for most cases of UUT stones in transplanted kidneys, except for simple and small stones in the middle or lower calyx.
He
Zhaohui
Z
Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, Guangdong, China.
Li
Xun
X
Chen
Lizhong
L
Zeng
Guohua
G
Yuan
Jian
J
D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*