title: Role of ultrasonography in percutaneous renal access in patients with renal anatomic abnormalities.
abstract: OBJECTIVE
  To present our experience regarding the feasibility, safety, and efficacy of ultrasound (US)-guided percutaneous nephrolithotomy in anatomically abnormal kidneys.
  
  
  METHODS
  We performed US-guided percutaneous nephrolithotomy in 15 patients with anatomically abnormal kidneys and renal calculi. Of the 15 patients, 5 had horseshoe kidneys, 5 had rotation anomalies, 2 had kyphoscoliosis, and 3 had scoliosis. The stone size, number of access tracts, operative time, hospitalization duration, rate of stone clearance, and complication rate were recorded. Percutaneous access was achieved with US guidance in the operating room by the urologist.
  
  
  RESULTS
  Successful renal access was obtained by the surgeon using US guidance in all patients, and a single access was obtained in all cases. Of the 15 patients, 8 were females, and 7 were males; 8 patients had solitary stones, and 7 had multiple calculi. The renal calculi were on the right in 7 patients and on the left in 8. Three patients had previously undergone unsuccessful shock wave lithotripsy. Complete stone clearance was achieved in 13 patients. The mean operative time was 54.2 minutes. No patient required a blood transfusion because of bleeding. Urinary tract infections occurred in 2 patients, who were treated with antibiotics. A double-J catheter was not inserted in any patient; however, a ureteral catheter was used in 3 patients for 1 day. None of the patients had any major complications during the postoperative period. The stone-free rate was 87%, and 2 patients had clinically insignificant residual fragments.
  
  
  CONCLUSIONS
  Our results have demonstrated that US-guided percutaneous nephrolithotomy can be performed feasibly, safely, and effectively in anatomically abnormal kidneys.
authors.affiliation: Department of Urology, Dicle University School of Medicine, Diyarbakir, Turkey. penbegul@yahoo.com
authors.forename: Necmettin
authors.initials: N
authors.lastname: Penbegul
authors.forename: Namik Kemal
authors.initials: NK
authors.lastname: Hatipoglu
authors.forename: Mehmet Nuri
authors.initials: MN
authors.lastname: Bodakci
authors.forename: Murat
authors.initials: M
authors.lastname: Atar
authors.forename: Yasar
authors.initials: Y
authors.lastname: Bozkurt
authors.forename: Ahmet Ali
authors.initials: AA
authors.lastname: Sancaktutar
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Tepeler
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D007669:Kidney Calculi / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D012189:Retrospective Studies; D014463:Ultrasonography; D018666:Ureteroscopy / Q000379:methods; D055815:Young Adult