title: Effects of Parenchymal Thickness and Stone Density Values on Percutaneous Nephrolithotomy Outcomes.
abstract: BACKGROUND It is unclear whether parenchymal thickness (PT), in combination with stone density measured by Hounsfield Units (HU), affects stone-free rates after PCNL. The aim of the present study was to investigate the relationship between PT in combination with stone density values and the outcomes of PCNL. MATERIAL AND METHODS From 2009 to 2014, data from 216 PCNL patients were prospectively analyzed. In total, 120 patients were included in the study. Using NCCT images, stone burden, stone localization, stone density as HU values, PT, and operative-postoperative parameters were recorded. RESULTS Stone localization, stone type, stone burden, and presence of hydronephrosis were statistically significant factors affecting stone-free status (p<0.001, p<0.001, p<0.01, and p<0.01, respectively). The stone-free rate in patients with thicker renal parenchyma was higher than in patients with lower parenchymal thickness (p<0.01). No correlation was detected between stone density and success rate (p>0.05). Drop in Hb (%) was only correlated with parenchymal thickness (p<0.01). In univariate analyses, factors that affected blood transfusion requirement were PT, BMI, and operative times (p<0.01, p<0.05, and p<0.05, respectively). CONCLUSIONS Stone location, stone burden, and presence of hydronephrosis detected with NCCT were factors affecting PCNL outcome. Stone density values did not correlate with the rate of bleeding or success of PCNL. PT measured by NCCT may predict bleeding and may guide surgeons in determining preoperative blood requirements. The outcome of PCNL appeared to be better in patients with thicker renal parenchyma and should be taken into consideration in the clinical evaluation of patients undergoing PCNL.
authors.affiliation: Department of Urology, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karalar
authors.affiliation: Department of Urology, Baskent University, Izmir, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Tuzel
authors.affiliation: Department of Urology, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Keles
authors.affiliation: Department of Radiology, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Nazan
authors.initials: N
authors.lastname: Okur
authors.affiliation: Department of Urology, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Hasmet
authors.initials: H
authors.lastname: Sarici
authors.affiliation: Department of Urology, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Ates
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000628:therapy; D007669:Kidney Calculi / Q000378:metabolism / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D000072356:Parenchymal Tissue; D012189:Retrospective Studies; D016896:Treatment Outcome