Abstract
ABSTRACTObjectives In this study it is aimed to compare the success and complication rates of SWL and RIRS in treatment of HSK stone disease.Materials and methods In this retrospective study data of 67 patients treated with either SWL (n=44) or RIRS (n=23) for stone disease in HSK between May 2003 to August 2014 was investigated. age, gender, stone size and multiplicity, stone free status, renal colic episodes and complication rates of the SWL and RIRS groups were compared.Results Mean age of the population was 42.5±8.2 (range: 16-78) years and mean stone size was 16.9±4.1 mm. SWL and RIRS groups were similar with regard to demographic characteristics and stone related characteristics. SFR of the SWL and RIRS groups were 47.7%(21/44 patients) and 73.9% (17/23 patients) respectively (p=0.039).Renal colic episodes were observed in 3 and 16 patients in the RIRS and SWL groups respectively (p=0.024). No statistically significant complications were observed between the SWL (8/44 patients) and RIRS (4/23) groups (p=0.936).Conclusions In HSK patients with stone disease, both SWL and RIRS are effective and safe treatment modalities. However RIRS seems to maintain higher SFRs with comparable complication rates.
Highlights
Renal anomalies are associated with increased rates of stone disease and the horseshoe kidney (HSK) is the most common renal fusion anomaly
retrograde intrarenal surgery (RIRS) is being increasingly used in the treatment of stone disease in HSK patients with holmium laser lithotriptors [4, 5]
A total of 52 stones in 44 patients and 32 stones in 23 patients were treated with shock wave lithotripsy (SWL) and RIRS respectively
Summary
Renal anomalies are associated with increased rates of stone disease and the horseshoe kidney (HSK) is the most common renal fusion anomaly. It is observed in approximately 1 in 400 to 1 in 666 births [1,2,3]. This anomaly leads to anterior displacement of the renal pelvis and associated high insertion of the ureter. This anatomical abnormality causes impaired drainage of the collecting system and urinary stasis and concomitant stone formation [2]. RIRS is being increasingly used in the treatment of stone disease in HSK patients with holmium laser lithotriptors [4, 5]
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