PERCUTANEOUS NEPHROLITHOTRIPSY IN PATIENTS AFTER DIFFERENT METHODS OF URINARY DIVERSION

The study presents the results of percutaneous nephrolithotripsy (PNL) in patients who underwent different methods of urinary diversion. Materials and methods: The study included the results of PNL in 16 patients (study group) with kidney stones who were subjected to different methods of urinary diversion. Earlier, 2 (12.5%) patients underwent bilateral ureterosigmoidostomy for bladder exstrophy, 12 (75%) experienced radical cystectomy with orthotopic ileocystoplasty and 2 (12.5%) - heterotopic cystoplasty. The control group comprised 30 patients with large kidney stones and normal function of the lower urinary tract. In the main group, the mean stone size was 2.5 (2.2-3.6) cm in the control group - 2.6 (2.4-3.8) cm. The puncture of the kidney cavity system and nephrostomy dilatation were performed under ultrasound and fluoroscopic guidance, respectively. We compared such factors as the surgery duration, the number of intra- and postoperative complications, blood loss and length of hospital stay. There were no hemorrhagic complications requiring blood transfusion. Exacerbation of chronic pyelonephritis occurred in 4 (25%) patients of the study group and in 3 (10%) of the control group (p<0.05). The two groups did not differ in the effectiveness of PNL (87.5 and 90.0% in the study and control groups, respectively), the blood loss volume and the length of hospital stay. Conclusion: PNL enables high effectiveness in removing large kidney stones with minimal complications in patients undergoing different methods of urinary diversion.

urinary diversion, intestinal cystoplasty, kidney stones, nephrolithiasis, percutaneous nephrolithotripsy