FIXATION OF THE KIDNEY IN ITS PHYSIOLOGICAL POSITION AS PREVENTION OF NEPHROLITHIASIS RELAPSE IN PATIENTS WITH CORAL STONES OF A SINGLE KIDNEY

Abstract

One kidney functions under stress during the first years after contralateral nephrectomy with a high risk of stone formation. A significant role in the recurrence of nephrolithiasis of a single kidney is played by a change in its physiological position (nephroptosis and kidney rotation in connection with vicarious hypertrophy). 64 patients with a single kidney were examined, repeatedly operated on for relapse of urolithiasis. The patients had anatomical and functional changes in the kidney; there was no tendency to lower blood pressure, especially in the presence of nephroptosis. Three patients underwent percutaneous nephrolithotripsy and nephropexy by our own methods. The described algorithm for performing the operation suggested by the authors is percutaneous nephrolithotripsy of single kidney stones and fixation of the kidney in its physiological position. In 41 patients with recurrent nephrolithiasis, who were operated twice or more, anatomic-functional changes of the kidney were found, there was no tendency to decrease blood pressure, especially in the presence of nephroptosis. All the patients underwent percutaneous nephrolithotripsy. Fixation of the kidney in its physiological position ensured the absence of nephroptosis, which is often associated with a single kidney due to its hypertrophy after removal of the contralateral one, provides an improvement in kidney function, prevents the relapse of nephrolithiasis, and nephrogenic hypertension. The effectiveness of kidney fixation in its physiological position to prevent recurrence of nephrolithiasis in patients with a single kidney is to reduce the traumatic and duration of the operation, accelerates the social rehabilitation of the patient, gives good long-term results.