La nephrolithotomie sur rein unique: a propos de vingt cas

Abstract

Introduction: Percutaneous nephrolithotomy (PCNL) is the most important therapeutic alternative in the management of large or complex renal calculi. Through a series of 20 patients, we study the feasibility and morbidity of this technique in a solitary kidney. Patients and methods: we retrospectively reviewed a series of twenty patients with a calculus in a solitary kidney during a 9-year period, all treated with (PCNL). The results were analyzed emphasizing complications with a special focus on the evolution of renal function. Results: Patients were divided into two groups depending on the size of the renal stone. The average age was 39 years (23-56 years). Pain was the dominant symptom, found in 60% of the patients. The stone free rate was 87.5% in group 1 and 84% in group 2. Further complementary treatment was necessary in 3 cases. Preoperative renal function was normal in 75% of the cases. After a moderate deterioration in the immediate postoperative period, renal function improved at one month follow up, and this improvement remained sustained for one year. Conclusion: The PCNL in a solitary kidney is safe and the results are comparable to those obtained with two functioning kidneys. Renal function is particularly not degraded in the medium or the long term.

Keywords: Urolithiasis; Solitary kidney; Percutaneous nephrolithotomy; Renal function

African Journal of Urology (2013) 19, 102–106