Treatment Of Renal Pelvic Stones Research Articles

Percutaneous Nephrolithotomy (PCNL) vs Retrograde Intrarenal Surgery (RIRS) in the Treatment of Renal Pelvic Stones Randomized Controlled Trial in IKD Hospital Peshawar

Background: Nephrolithiasis is a common disease with a 10% lifetime risk in men and 5% in women. With the emergence of noninvasive and minimally invasive methods, the management of renal stones has vastly improved. Objective: Comparison of effectiveness of percutaneous nephrolithotomy vs retrograde intrarenal surgery for the treatment of renal pelvis stones. Methodology: This study was randomized controlled trial carried out at the Department of Urology and Renal Transplantation, Institute of Kidney Diseases Hayatabad Medical Complex,Peshawar for six months from 23-09-2018 to 22-03-2019. Total sample size was 70 patients. Patients in group A underwent Percutaneous Nephrolithotomy (PCNL) and Group B will be subjected to RIRS. All the patients will be advised for follow up visit at 2 weeks post operatively to determine intervention effectiveness in terms of complete stone clearance. Results: The mean size of the stone was 17.47mm ± 1.7SD, ranges 15 to 20 mm in both groups. In group A, PCNL Procedure was effective in 34(97.1%) patients at completion of study. While in group B, 28(80%) patients were effectively stone cleared. which is significant with p-value=0.027. Conclusion: Percutaneous Nephrolithotomy (PCNL) is more efficient and safe procedure for renal stone of size 1.5cm to 2 cm as compared to RIRS. Studies show that PCNL is more effective than retrograde intrarenal surgery in the treatment of renal pelvis stones. In the light of recent data, PCNL seems to be an ideal treatment modality in the management of patients. Nevertheless, these results must be confirmed by further prospective large randomized trials. Keywords: Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, Renal Stones

Extracorporeal Shock Wave Lithotripsy of Renal Pelvis Stones with PCK Stonelith Lithotripter

Shock wave lithotripsy (SWL) has made a revolution in the treatment of urolithiasis. It is a safe procedure with a lower morbidity than open surgery or percutaneous nefrolithotomy (PCN). In this article, we analyze our results of SWL with PCK Stonelith-V5 Lithotripter for the renal pelvis localized stones. About 97 patients with radiopaque stone localized in the renal pelvis were treated with PCK lithotripter from January 2001 to March 2003. The study group was divided into two groups according to their stone size. The stone size was < or = 10 mm in the first group and 11-20 mm in the second group. 56(57) patients were male and 41 (43) were female. Age range was 7-68 (mean 44) years. The overall success rates of SWL for the treatment of renal pelvic stones in our study group was 35 and 62.2 for stones 10 mm or less and 11-20 mm, respectively. Since the focal zone is 7.7 x 30 mm, the stones can easily get out of the focal zone area with respiration and as a result, the success rate is decreased. So, general anesthesia can be preferred for the treatment of stones < or =10 mm with the PCK Stonelith Lithotripter.