1585 THE EFFECTS OF SWL FAILURE ON OUTCOMES OF SUBSEQUENT PNL IN PATIENTS WITH RENAL CALCULI

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopic or Percutaneous Stone Removal II1 Apr 20101585 THE EFFECTS OF SWL FAILURE ON OUTCOMES OF SUBSEQUENT PNL IN PATIENTS WITH RENAL CALCULI Joo Yong Lee, Joon Seok Kwon, Sung Yul Park, Young Woo Son, Hong Sang Moon, Yong Tae Kim, Hong Yong Choi, and Tchun Yong Lee Joo Yong LeeJoo Yong Lee More articles by this author , Joon Seok KwonJoon Seok Kwon More articles by this author , Sung Yul ParkSung Yul Park More articles by this author , Young Woo SonYoung Woo Son More articles by this author , Hong Sang MoonHong Sang Moon More articles by this author , Yong Tae KimYong Tae Kim More articles by this author , Hong Yong ChoiHong Yong Choi More articles by this author , and Tchun Yong LeeTchun Yong Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1351AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Shockwave lithotripsy (SWL) and percutaneous nephrolithotripsy (PNL) is mainstay in treating renal calculi. Especially, PNL is prime treatment when SWL fails. The purpose of this study is to evaluate effects of SWL failure on the outcomes of subsequent PNL. METHODS The study population included 108 patients who underwent PNL from January 2002 to June 2009. In all, 73 patients underwent PNL alone for treating renal calculi (Group 1) and 35 underwent PNL after SWL failure (Group 2). Characteristics of patients and calculi included age, gender, body mass index, ASA score, size of renal calculi, location of calculi, presence of staghorn stone, bilaterality, multiplicity, and presence of hydronephrosis. The outcomes of PNL were assessed by factors of operation time, duration of hospitalization, duration of nephrostomy catheterization, estimated blood loss, transfusion rate, success rate, and stone free rate. Success was defined as presence of asymptomatic remnant calcifications less than 0.4cm on plain KUB film. RESULTS Characteristics of patients and calculi showed no significant difference between two groups. Mean size of calculi in both groups were 2.79±1.68 and 2.45±1.28 cm, respectively (p=0.307). Percentage of multiplicity was 49.3 and 68.6%. (p=0.059). Mean duration of nephrostomy catheterization was 5.67±2.13 days in group 1 and 7.34±3.92 days in group 2 (p=0.023). Mean duration of hospitalization was also shorter in group1 (11.18±5.02 vs 14.00±7.46 days) (p=0.048). There was no significant difference in operation time between two groups. However, noticeable statistical differences were present regarding estimated blood loss (195.89 vs 528.57 mL, p=0.001) and transfusion rate (16.4 vs 51.4%, p<0.001) between two groups. Success rate (83.6 vs 88.6%, p=0.493) and stone free rate (74.0 vs 74.3%, p=0.951) were equal in both groups. CONCLUSIONS Subsequent PNL after SWL failure was as successful as PNL performed alone. However, patients treated with PNL after failure of SWL showed more blood loss, higher transfusion rate, thus longer hospitalization. Seoul, Republic of Korea© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e612-e613 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joo Yong Lee More articles by this author Joon Seok Kwon More articles by this author Sung Yul Park More articles by this author Young Woo Son More articles by this author Hong Sang Moon More articles by this author Yong Tae Kim More articles by this author Hong Yong Choi More articles by this author Tchun Yong Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...