Skip to main content
Erschienen in: World Journal of Urology 3/2015

01.03.2015 | Original Article

Is retrograde intrarenal surgery a viable treatment option for renal stones in patients with solitary kidney?

verfasst von: G. Giusti, S. Proietti, L. Cindolo, R. Peschechera, G. Sortino, F. Berardinelli, G. Taverna

Erschienen in: World Journal of Urology | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the effectiveness and safety of retrograde intrarenal surgery (RIRS) for stones up to 2 cm in diameter in patients with solitary kidney.

Methods

From January 2008 to January 2013, we prospectively enrolled all consecutive patients with solitary kidney and renal stones. Plain abdominal computed tomography scan was performed preoperatively and 1 month after the procedure to assess the stone-free rates (SFR). Serum creatinine levels were detected preoperatively, at day 1 postoperatively, at 1 month postoperatively, and then every 6 months postoperatively.

Results

During the study period, we prospectively enrolled a total of 29 patients. The mean age was 55.7 ± 12.3 years; the mean stone size was 1.3 ± 0.4 cm. The primary SFR was 72.4 %; the secondary SFR was 93.1 %. The mean number of procedures per patient was 1.24. The mean serum creatinine levels were 1.5 ± 0.6, 1.6 ± 0.7, 1.6 ± 0.6, and 1.7 ± 0.7 mg/dl preoperatively, at 1 day after RIRS, at 1 month after RIRS, and at 1 year after RIRS, respectively, without detection of any statistical difference (p = 0.76). Median follow-up time was 35.7 ± 19.3 (12–72) months, but that was available for only 18 patients. The mean serum creatinine level at the last follow-up was 1.7 ± 0.9 mg/dl. No major complications were recorded. Grade I complications occurred in eight patients (27.4 %).

Conclusions

RIRS is safe and effective in the treatment of renal stones in patients with solitary kidney, without worsening renal function.
Literatur
1.
Zurück zum Zitat Atis G, Gurbuz C, Arikan O, Kilic M, Pelit S, Canakci C, Gungor S, Caskurlu T (2013) Retrograde intrarenal surgery for the treatment of renal stones in patients with a solitary kidney. Urology 82:290–294CrossRefPubMed Atis G, Gurbuz C, Arikan O, Kilic M, Pelit S, Canakci C, Gungor S, Caskurlu T (2013) Retrograde intrarenal surgery for the treatment of renal stones in patients with a solitary kidney. Urology 82:290–294CrossRefPubMed
2.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of survey. Ann Surg 240:205–213CrossRefPubMedCentralPubMed Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of survey. Ann Surg 240:205–213CrossRefPubMedCentralPubMed
3.
Zurück zum Zitat Tan YM, Yip SK, Chong TW, Wong MY, Cheng C, Foo KT (2002) Clinical experience and results of ESWL treatment for 3,093 urinary calculi with the Storz Modulith SL 20 lithotripter at the Singapore general hospital. Scand J Urol Nephrol 36:363–367CrossRefPubMed Tan YM, Yip SK, Chong TW, Wong MY, Cheng C, Foo KT (2002) Clinical experience and results of ESWL treatment for 3,093 urinary calculi with the Storz Modulith SL 20 lithotripter at the Singapore general hospital. Scand J Urol Nephrol 36:363–367CrossRefPubMed
4.
Zurück zum Zitat Zanetti GR, Montanari E, Guarneri A, Trinchieri A, Mandressi A, Ceresoli A (1992) Long-term followup after extracorporeal shock wave lithotripsy treatment of kidney stones in solitary kidneys. J Urol 148:1011–1014PubMed Zanetti GR, Montanari E, Guarneri A, Trinchieri A, Mandressi A, Ceresoli A (1992) Long-term followup after extracorporeal shock wave lithotripsy treatment of kidney stones in solitary kidneys. J Urol 148:1011–1014PubMed
5.
Zurück zum Zitat Chandhoke PS, Albala DM, Clayman RV (1992) Long-term comparison of renal function in patients with solitary kidneys and/or moderate renal insufficiency undergoing extracorporeal shock wave lithotripsy or percutaneous nephrolithotomy. J Urol 147:1226–1230PubMed Chandhoke PS, Albala DM, Clayman RV (1992) Long-term comparison of renal function in patients with solitary kidneys and/or moderate renal insufficiency undergoing extracorporeal shock wave lithotripsy or percutaneous nephrolithotomy. J Urol 147:1226–1230PubMed
6.
Zurück zum Zitat Evan AP, Willis LR, Lingeman JE, McAteer JA (1998) Renal trauma and the risk of long-term complications in shock wave lithotripsy. Nephron 78:1–8CrossRefPubMed Evan AP, Willis LR, Lingeman JE, McAteer JA (1998) Renal trauma and the risk of long-term complications in shock wave lithotripsy. Nephron 78:1–8CrossRefPubMed
7.
Zurück zum Zitat Cass AS (1994) Renal function after extracorporeal shock wave lithotripsy to a solitary kidney. J Endourol 8:15–19CrossRefPubMed Cass AS (1994) Renal function after extracorporeal shock wave lithotripsy to a solitary kidney. J Endourol 8:15–19CrossRefPubMed
8.
Zurück zum Zitat Wiesenthal JD, Ghiculete D, D’A Honey RJ, Pace KT (2010) Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi. Urol Res 38:307–313CrossRefPubMed Wiesenthal JD, Ghiculete D, D’A Honey RJ, Pace KT (2010) Evaluating the importance of mean stone density and skin-to-stone distance in predicting successful shock wave lithotripsy of renal and ureteric calculi. Urol Res 38:307–313CrossRefPubMed
9.
Zurück zum Zitat Sofer M, Watterson JD, Wollin TA, Nott L, Razvi H, Denstedt JD (2002) Holmium: YAG laser lithotripsy for upper urinary tract calculi in 598 patients. J Urol 167:31–34CrossRefPubMed Sofer M, Watterson JD, Wollin TA, Nott L, Razvi H, Denstedt JD (2002) Holmium: YAG laser lithotripsy for upper urinary tract calculi in 598 patients. J Urol 167:31–34CrossRefPubMed
10.
Zurück zum Zitat Miernik A, Wilhelm K, Ardelt PU, Adams F, Kuehhas FE, Schoenthaler M (2012) Standardized flexible ureteroscopic technique to improve stone-free rates. Urology 80:1198–1202CrossRefPubMed Miernik A, Wilhelm K, Ardelt PU, Adams F, Kuehhas FE, Schoenthaler M (2012) Standardized flexible ureteroscopic technique to improve stone-free rates. Urology 80:1198–1202CrossRefPubMed
11.
Zurück zum Zitat El-Nahas AR, Ibrahim HM, Youssef RF, Sheir KZ (2012) Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10–20 mm. BJU Int 110:898–902CrossRefPubMed El-Nahas AR, Ibrahim HM, Youssef RF, Sheir KZ (2012) Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10–20 mm. BJU Int 110:898–902CrossRefPubMed
12.
Zurück zum Zitat Bryniarski P, Paradysz A, Zyczkowski M, Kupilas A, Nowakowski K, Bogacki R (2012) A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than 2 cm in diameter. J Endourol 26:52–57CrossRefPubMed Bryniarski P, Paradysz A, Zyczkowski M, Kupilas A, Nowakowski K, Bogacki R (2012) A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than 2 cm in diameter. J Endourol 26:52–57CrossRefPubMed
13.
Zurück zum Zitat Michel MS, Trojan L, Rassweiler JJ (2007) Complications in percutaneous nephrolithotomy. Eur Urol 51:899–906CrossRefPubMed Michel MS, Trojan L, Rassweiler JJ (2007) Complications in percutaneous nephrolithotomy. Eur Urol 51:899–906CrossRefPubMed
14.
Zurück zum Zitat Bucuras V, Gopalakrishnam G, Wolf JS Jr, Sun Y, Bianchi G, Erdogru T, de la Rosette J, CROES PCNL Study Group (2012) The clinical research office of the endourological society percutaneous nephrolithotomy global study: nephrolithotomy in 189 patients with solitary kidneys. J Endourol 26:336–341CrossRefPubMed Bucuras V, Gopalakrishnam G, Wolf JS Jr, Sun Y, Bianchi G, Erdogru T, de la Rosette J, CROES PCNL Study Group (2012) The clinical research office of the endourological society percutaneous nephrolithotomy global study: nephrolithotomy in 189 patients with solitary kidneys. J Endourol 26:336–341CrossRefPubMed
15.
Zurück zum Zitat Wong KA, Sahai A, Patel A, Thomas K, Bultitude M, Glass J (2013) Is percutaneous nephrolithotomy in solitary kidneys safe? Urology 82:1013–1016CrossRefPubMed Wong KA, Sahai A, Patel A, Thomas K, Bultitude M, Glass J (2013) Is percutaneous nephrolithotomy in solitary kidneys safe? Urology 82:1013–1016CrossRefPubMed
16.
Zurück zum Zitat Canes D, Hegarty NJ, Kamoi K, Haber GP, Berger A, Aron M, Desai MM (2009) Functional outcomes following percutaneous surgery in the solitary kidney. J Urol 181:154–160CrossRefPubMed Canes D, Hegarty NJ, Kamoi K, Haber GP, Berger A, Aron M, Desai MM (2009) Functional outcomes following percutaneous surgery in the solitary kidney. J Urol 181:154–160CrossRefPubMed
17.
Zurück zum Zitat Kiliç S, Oğuz F, Kahraman B, Altunoluk B, Ergin H (2008) Prospective evaluation of the alterations in the morphology and vascular resistance of the renal parenchyma with color Doppler ultrasonography after percutaneous nephrolithotomy. J Endourol 22:615–621CrossRefPubMed Kiliç S, Oğuz F, Kahraman B, Altunoluk B, Ergin H (2008) Prospective evaluation of the alterations in the morphology and vascular resistance of the renal parenchyma with color Doppler ultrasonography after percutaneous nephrolithotomy. J Endourol 22:615–621CrossRefPubMed
18.
Zurück zum Zitat Sharifiaghdas F, Kashi AH, Eshratkhah R (2011) Evaluating percutaneous nephrolithotomy-induced kidney damage by measuring urinary concentrations of β2-microglobulin. Urol J 8:277–282PubMed Sharifiaghdas F, Kashi AH, Eshratkhah R (2011) Evaluating percutaneous nephrolithotomy-induced kidney damage by measuring urinary concentrations of β2-microglobulin. Urol J 8:277–282PubMed
19.
Zurück zum Zitat Clayman RV, Elbers J, Miller RP, Williamson J, McKeel D, Wassynger W (1987) Percutaneous nephrostomy: assessment of renal damage associated with semi-rigid (24F) and balloon (36F) dilation. J Urol 138:203–206PubMed Clayman RV, Elbers J, Miller RP, Williamson J, McKeel D, Wassynger W (1987) Percutaneous nephrostomy: assessment of renal damage associated with semi-rigid (24F) and balloon (36F) dilation. J Urol 138:203–206PubMed
20.
Zurück zum Zitat Wilson WT, Preminger GM (1990) Intrarenal pressures generated during flexible deflectable ureterorenoscopy. J Endourol 4:135–142CrossRef Wilson WT, Preminger GM (1990) Intrarenal pressures generated during flexible deflectable ureterorenoscopy. J Endourol 4:135–142CrossRef
21.
Zurück zum Zitat Auge BK, Pietrow PK, Lallas CD, Raj GV, Santa-Cruz RW, Preminger GM (2004) Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol 18:33–36CrossRefPubMed Auge BK, Pietrow PK, Lallas CD, Raj GV, Santa-Cruz RW, Preminger GM (2004) Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol 18:33–36CrossRefPubMed
22.
Zurück zum Zitat Stern JM, Yiee J, Park S (2007) Safety and efficacy of ureteral access sheaths. J Endourol 21:119–123CrossRefPubMed Stern JM, Yiee J, Park S (2007) Safety and efficacy of ureteral access sheaths. J Endourol 21:119–123CrossRefPubMed
23.
Zurück zum Zitat Schwalb DM, Eshghi M, Davidian M, Franco I (1993) Morphological and physiological changes in the urinary tract associated with ureteral dilation and ureteropyeloscopy: an experimental study. J Urol 149:1576–1585PubMed Schwalb DM, Eshghi M, Davidian M, Franco I (1993) Morphological and physiological changes in the urinary tract associated with ureteral dilation and ureteropyeloscopy: an experimental study. J Urol 149:1576–1585PubMed
24.
Zurück zum Zitat Traxer O, Thomas A (2013) Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol 189:580–584CrossRefPubMed Traxer O, Thomas A (2013) Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol 189:580–584CrossRefPubMed
25.
Zurück zum Zitat Delvecchio FC, Auge BK, Brizuela RM, Weizer AZ, Silverstein AD, Lallas CD, Pietrow PK, Albala DM, Preminger GM (2003) Assessment of stricture formation with the ureteral access sheath. Urology 61:518–522CrossRefPubMed Delvecchio FC, Auge BK, Brizuela RM, Weizer AZ, Silverstein AD, Lallas CD, Pietrow PK, Albala DM, Preminger GM (2003) Assessment of stricture formation with the ureteral access sheath. Urology 61:518–522CrossRefPubMed
Metadaten
Titel
Is retrograde intrarenal surgery a viable treatment option for renal stones in patients with solitary kidney?
verfasst von
G. Giusti
S. Proietti
L. Cindolo
R. Peschechera
G. Sortino
F. Berardinelli
G. Taverna
Publikationsdatum
01.03.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 3/2015
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-014-1305-6

Weitere Artikel der Ausgabe 3/2015

World Journal of Urology 3/2015 Zur Ausgabe

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.