title: Does pelvicaliceal system anatomy affect success of percutaneous nephrolithotomy?
abstract: OBJECTIVE
  To investigate the effect of the pelvicaliceal system (PCS) anatomy on the percutaneous nephrolithotomy (PCNL) success rate. Although the caliceal anatomy is effective for stone clearance after shock wave lithotripsy and retrograde intrarenal lithotripsy, the effect of the caliceal anatomy after PCNL has not been evaluated to date.
  
  
  METHODS
  A total of 498 patients who had undergone PCNL and preoperative intravenous urography were enrolled in our study. Kidney-related anatomic factors, such as the PCS surface area and type, degree of hydronephrosis, infundibulopelvic angle, upper-lower calix angle, infundibular length, and infundibular width were calculated using intravenous urography. The association between the PCNL success rate and kidney-related anatomic factors was retrospectively analyzed using chi-square tests, Fisher's exact test, Mann-Whitney U test, and forward stepwise regression analysis.
  
  
  RESULTS
  A success rate of 78.1% was achieved. No difference was seen the success rates among the PCS types. The mean PCS surface area was 20.1 ± 9.7 cm(2) in patients with successful outcomes and 24.5 ± 10.2 cm(2) in patients with remaining stones (P = .001). The mean infundibulopelvic angle, upper-lower calix angle, infundibular length, and infundibular width were similar in both groups. Multivariate binary logistic regression analysis showed that stone configuration and PCS surface area were independent factors affecting the PCNL success rates.
  
  
  CONCLUSIONS
  The results of our study have shown that the PCS surface area is the only anatomic factor that affects the PCNL success rate and patients with a PCS surface area <20.5 cm(2) have greater PCNL success.
authors.affiliation: Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey. muratbinbay@yahoo.com
authors.forename: Murat
authors.initials: M
authors.lastname: Binbay
authors.forename: Tolga
authors.initials: T
authors.lastname: Akman
authors.forename: Faruk
authors.initials: F
authors.lastname: Ozgor
authors.forename: Ozgur
authors.initials: O
authors.lastname: Yazici
authors.forename: Erhan
authors.initials: E
authors.lastname: Sari
authors.forename: Akif
authors.initials: A
authors.lastname: Erbin
authors.forename: Cem
authors.initials: C
authors.lastname: Kezer
authors.forename: Omer
authors.initials: O
authors.lastname: Sarilar
authors.forename: Yalcın
authors.initials: Y
authors.lastname: Berberoglu
authors.forename: Ahmet Yaser
authors.initials: AY
authors.lastname: Muslumanoglu
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology*; D007669:Kidney Calculi / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D010388:Pelvis / Q000033:anatomy & histology / Q000473:pathology*; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome