title: Percutaneous nephrolithotomy in patients with a solitary kidney.
abstract: METHODS
  The results of percutaneous nephrolithotomy applied to 716 patients in our clinic between January 2008 and January 2014 were retrospectively evaluated. Age, gender, urinary calculi size (mm(2)), urinary calculi localization, ESWL history, operation duration (min), fluoroscopy duration (sec), access type, reason of solitary kidney, hemoglobin drawdown (g/dl) and operation success of the patients with a solitary kidney were recorded. The patients having no preoperative and postoperative non contrast abdominal tomography were excluded from the study.
  
  
  RESULTS
  Fifteen of nineteen patients (79%) were men and 4 of them (21%) were women. The average age of the patients was 42.52 ± 16.72 (14-72). Ten patients had anatomical solitary kidney and nine patients had physiological solitary kidney. In fact counter kidney was non functional in 9 patients (47%) whereas there was agenesis in 2 (11%) and outcome of nephrectomy in 8 (42%) patients. In our study, presence of residual stone less than 4 mm at 1st month postoperative non contrast abdominal tomography was accepted as a successful result and accordingly our success rate was detected as 84%. Mean urinary calculi size was 405 ± 252.9 mm(2); urinary calculi localization was pelvic, lower pole, upper-middle pole, middle-lower pole and staghorn in 11 (58%), 4 (21%), 1 (5%), 1 (5%) and 1 (5%) patients, respectively; previous ESWL history was 16%; operation duration was 55.47-± 28.1 min and fluoroscopy duration 131.10 ± 87.6 sec; access type was subcostal in 79%, supracostal in 10.5% and multiple in 10.5%; hemoglobin drawdown was 1.75 ± 0.97 mg/dl.
  
  
  CONCLUSIONS
  PNL can be effectively and safely administered for the treatment of solitary kidney. In the treatment of large urinary calculi in patients with a solitary kidney, PNL has some advantages such as short surgery duration, less complication, acceptable hemoglobin drawdown and high success rates. According to our study, PNL operation in patients with a solitary kidney is a good option for carefully and poisedly selected cases.
authors: Tepecik Training and Research Hospital, Urology Clinic, Izmir. tsuelozgen@hotmail.com.
authors: Tufan
authors: T
authors: Süelözgen
authors: Salih
authors: S
authors: Budak
authors: Orcun
authors: O
authors: Celik
authors: Okan
authors: O
authors: Yalbuzdag
authors: Oguz
authors: O
authors: Mertoglu
authors: Selcuk
authors: S
authors: Isoglu
authors: Mehmet
authors: M
authors: Yoldas
authors: Yusuf Ozlem
authors: YO
authors: Ilbey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D007669:Kidney Calculi / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D012189:Retrospective Studies; D055815:Young Adult