Indications, Complications and Mortality of Nephrectomy in Tikur Anbesa General Specialized Hospital

Abstract

Background: Nephrectomy is a standard therapeutic urological procedure for malignancy of kidneys and upper urinary tract, and for damaged kidneys with little or no contribution to the overall renal function. There are geographical variations in indications for nephrectomy as certain urological diseases are more prevalent in some countries. Many complications are associated with nephrectomy and Nephrectomy for malignant disease had a significantly higher rate of complications than operations for benign conditions. The purpose of this study was to gain information about the indications for and complications of conventional nephrectomy in TAH, Ethiopia
Methods: This study is a two years retrospective analysis of patients who underwent nephrectomy at Tikur Anbessa hospital from September 2009 to august 2011. Medical records of patients who underwent nephrectomy during the two years period were studied by using a preset questionnaire with regards to their age, sex, clinical presentation, investigation (laboratory and imaging), indication for nephrectomy and post-operative course.
Results: During the two years study period (September 2009 to August 2011), a total of 73 nephrectomy were performed. Forty (54.8%) patients were males and 33 (45.2%) were females. The most common presenting symptom was loin pain (100%) followed by haematuria 32(43.5%) and abdominal or flank mass 26 (35.6%). Among patients who underwent nephrectomy, 38(51.2%) had none or poor functioning kidney due to obstructive uropathy.
Discussion: In our study 46 (63%) patients underwent nephrectomy for benign conditions, which is comparable with the series reported from developing countries like Pakistan, India, Jordan and Saudi Arabia. Most of our patients had non-functioning kidney secondary to obstruction due to stone disease.

Conclusion: There is a higher rate of nephrectomy performed for benign conditions in TAGSH. Late presenting obstructive uropathy due to stone causing loss of renal function was common in our study.