title: Surgical management of urolithiasis in patients after urinary diversion.
abstract: OBJECTIVE
  To present our experience in surgical management of urolithiasis in patients after urinary diversion.
  
  
  METHODS
  Twenty patients with urolithiasis after urinary diversion received intervention. Percutaneous nephrolithotomy, percutaneous based antegrade ureteroscopy with semi-rigid or flexible ureteroscope, transurethral reservoir lithotripsy, percutaneous pouch lithotripsy and open operation were performed in 8, 3, 2, 6, and 1 patients, respectively. The operative finding and complications were retrospectively collected and analyzed.
  
  
  RESULTS
  The mean stone size was 4.5 ± 3.1 (range 1.5-11.2) cm. The mean operation time was 82.0 ± 11.5 (range 55-120) min. Eighteen patients were rendered stone free with a clearance of 90%. Complications occurred in 3 patients (15%). Two patients (10%) had postoperative fever greater than 38.5 °C, and one patient (5%) suffered urine extravasations from percutaneous tract.
  
  
  CONCLUSIONS
  The percutaneous based procedures, including percutaneous nephrolithotomy, antegrade ureteroscopy with semi-rigid ureteroscope or flexible ureteroscope from percutaneous tract, and percutaneous pouch lithotripsy, provides a direct and safe access to the target stones in patients after urinary diversion, and with high stone free rate and minor complications. The surgical management of urolithiasis in patients after urinary diversion requires comprehensive evaluation and individualized consideration depending upon the urinary diversion type, stone location, stone burden, available resource and surgeon experience.
authors.affiliation: Department of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhong
authors.affiliation: Department of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China.
authors.forename: Bicheng
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Gynecology and Obstetrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Fang
authors.initials: F
authors.lastname: He
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson, Tennessee, United States of America.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Sunil
authors.initials: S
authors.lastname: Swami
authors.affiliation: Department of Urology, the First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Guangzhou, China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Zeng
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000209:etiology* / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects*