Effects of minimally invasive percutaneous nephrolithotomy combined with extracorporeal shock wave lithotripsy in patients with complex renal calculi

Abstract

Objective To investigate the effect of minimally invasive percutaneous nephrolithotomy combined with extracorporeal shock wave lithotripsy on postoperative serum β2-microglobulin (β2-MG), retinol binding protein (RBP) levels and sexual function in patients with complex renal calculi. Methods From October 2013 to October 2016, 93 patients with complex renal calculi in our hospital were selected and were divided into control group (n=46) and observation group (n=47) according to different surgical procedures. The control group was treated with open nephrectomy, while the observation group was treated with minimally invasive percutaneous nephrolithotomy combined with extracorporeal shock wave lithotripsy. Surgery condition, complications were compared between the two groups, and serum β2-MG, RBP, serum creatinine (Scr) levels before and 1 week after the operation, sexual function score and quality of life score (SF-36) 6 months after the operation were compared. Results Compared with the control group, the operation time of the observation group was prolonged, but the intraoperative blood loss was decreased, the hospitalization time and getting out of bed time were shortened, and the stone clearance rate was improved, with statistically significant differences (P 0.05); compared with the control group, serum β2-MG and Scr levels were decreased in the observation group and serum RBP level was increased at 1 week after the operation, with statistically significant differences (P<0.05). The scores of sexual arousal, sexual desire, orgasm, sexual satisfaction of patients and their spouse, and other sexual function of the observation group were higher than those of the control group at 6 months after the operation, with statistically significant differences (P<0.05). The SF-36 scores of the two groups at 6 months after the operation were higher than those before the operation, and that of the observation group was higher than that of the control group, with statistically significant difference (P<0.05). The incidence of postoperative complications in the observation group [8.51% (4/47)] was lower than that in the control group [28.26% (13/46)], with statistically significant difference (P<0.05). Conclusion Minimally invasive percutaneous nephrolithotomy combined with extracorporeal shock wave lithotripsy in the treatment of patients with complex renal calculi has a significant effect, which can significantly improve serum β2-MG, RBP, and Scr levels, improve their renal function and sexual function, reduce the intraoperative bleeding and the incidence of complications, promote patients’ rehabilitation, improve their quality of life. Key words: Complex renal calculi; Minimally invasive percutaneous nephrolithotomy; Extracorporeal shock wave lithotripsy; β2-MG; RBP; Sexual function; Complication