Percutaneous nephrolithotomy of horseshoe kidney: Our institutional experience

• Main Authors: Vikram Satav, Vilas Sabale, Prasun Pramanik, Sharad P Kanklia, Sunil Mhaske
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Urology Annals
• Subjects: Horseshoe kidney; percutaneous nephrolithotomy; Kidney anomalies; urolithiasis; Eswl
• Online Access: http://www.urologyannals.com/article.asp?issn=0974-7796;year=2018;volume=10;issue=3;spage=258;epage=262;aulast=Satav
• ISSN: 0974-7796; 0974-7834

Purpose: To review our success in PCNL for managing large horse shoe kidney stones as primary treatment . Method: Between 2012 and 2016, a total of 23patients (24 renal units) underwent percutaneous renal surgery for stone dieses in horseshoe kidneys. Indications were HSK with stone more than 1 cm in size and failed ESWL. Results: Mean age was 35.60 ± 10.10 years out of which 18 were males and 5 females .One patient had stone in both kidneys. Mean stone size was 22.03 ± 10.33 mm . Access site was upper calyceal and subcostal in all patients. In 2 patients an extra middle calyceal puncture were used for total clearance (8.69%). Mean operation time was 67.22 ± 7.63 minutes. One patient with staghorn stone was converted to open surgery because of inaccessibility of the stone and complexity of the renal calyceal system. Post operatively, 2 renal units with residual stone more than 8mm were cleared with ESWL. Complete clearance was achieved in 21 renal units with PCNL (87.50%). There was no significant intra operative complication. Post operatively 2 patients developed fever which was treated conservatively(clavien grade I). Conclusion: PCNL can be recommended as first line of management in the treatment of horseshoe kidneys with large stone burden considering its higher clearance rate and minimal complications.