The treatment of renal lower pole calculi with flexible ureteroscope and percutaneous nephrolithotomy in obese patients

Abstract

Objective To evaluate the efficacy and safety of flexible ureteroscopy (FURS) for the treatment of renal lower pole calculi in obese patients. Methods From October 2012 to May 2017, a total number of 184 obese patients(body mass index, BMI≥30) with lower pole kidney stones were randomly divided into two groups, FURS group(n=65) and percutaneous nephrolithotomy(PNL) group (n=119). The mean stone size was (15.8±5.7)mm in FURS group and (18.6±4.9)mm in PNL group. Results All of the D-J stents were removed 4 weeks after operation in both groups, and ultrasonic or X-Ray 87.69% vs. 89.92% (P>0.05). Residual stones were found in 8 vs. 12 patients in each group, and all disappeared after active lithagogue treatment with external physical vibration lithecbole (EPVL). Complications in FURS group were lower than PNL group , including fever(1 vs. 2), pain(8 vs. 23), perirenal hematoma(none vs. 1) , the visual analogue scale/score(3.3±1.1) vs.(5.6±0.9) and hospital stay(3.7±0.6) d vs. (5.4±0.8 ) d was also lower(P<0.05). Conclusions FURS is a safe and efficient option for renal lower pole calculi in obese patients. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Ureteroscopes; Obesity