| Percutaneous Nephrolithotripsy in Patients with Urinary Diversions: A Case-Control Comparison of Perioperative Outcomes. | |
| | |
MedLine Citation:
|
PMID: 21823981 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Abstract Purpose: To compare the operative techniques and perioperative outcomes of patients with urinary intestinal diversions undergoing percutaneous nephrolithotripsy (PCNL), to a control cohort of patients without diversions. Patients and Methods: The medical records of all patients who were treated with PCNL from 1990 to 2009 were retrospectively reviewed. Each urinary diversion patient's first PCNL was age-matched with four controls who were undergoing PCNL. The perioperative outcomes were compared between the diversion and control cohorts. Results: Twenty-five patients with a urinary diversion who had undergone 33 PCNLs were identified. The mean age was 49.3 (8-85) years for the diversion group and 48.9 (4-84) for the control group. Urinary tract infection (64% vs 15% patients, P<0.0001), neurologic disease (64% vs 2%, P<0.0001), previous procedure for the same calculus (24% vs 4%, P=0.0004), urinary tract abnormalities (56% vs 14%, P<0.0001), solitary kidney (20% vs 3%, P=0.0081), and struvite stones (80% vs 12.5%, P=0.0006) were more commonly observed in the diversion group. Percutaneous access gained by a radiologist (40% vs 0%, P<0.0001), second-look nephroscopy (36% vs 16%, P=0.0466), and an increase in the frequency of fever or sepsis (8% vs 0%, P=0.0387) were identified more frequently in the diversion group. Conclusions: Patients with upper tract calculi and urinary diversions are challenging to the endourologist because of anatomic factors that can make percutaneous access more difficult; ultrasonography-guided access can be helpful in this setting. Patients with urinary diversions can be treated as safely and effectively by PCNL as nondiverted patients. |
| | |
Authors:
|
Alfonso Fernandez; Kirsten Foell; Linda Nott; John D Denstedt; Hassan Razvi |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-8-8 |
Journal Detail:
|
Title: Journal of endourology / Endourological Society Volume: - ISSN: 1557-900X ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
|
Created Date: 2011-8-9 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8807503 Medline TA: J Endourol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Division of Urology, Department of Surgery, Schulich School of Medicine & Dentistry, The University of Western Ontario , London, Ontario, Canada . |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A randomized, double-blind clinical trial comparing the effects of continuous and pulsed ultrasound ...
Next Document: Laparoendoscopic Single-Site Varicocele Repair in Adolescents-Initial Experience at a Single Institu...