Efficacy of Percutaneous Nephrolithotomy in Patients with Neurogenic Bladder Dysfunction
Aim: Patients with neurogenic bladder dysfunction (NBD) are at increased risk of urolithiasis. We review our experience with percutaneous nephrolithotomy (PCNL) on this group of patients with special attention paid to the risks of surgical complications. Methods: A total of 18 cases with NBD und...
Main Authors: | , , |
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Format: | Article |
Language: | English |
Published: |
Galenos Yayinevi
2010-09-01
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Series: | Haseki Tıp Bülteni |
Subjects: | |
Online Access: | http://www.hasekidergisi.com/makale_4577/Efficacy-Of-Percutaneous-Nephrolithotomy-In-Patients-With-Neurogenic-Bladder-Dysfunction-Original-Article |
Summary: | Aim: Patients with neurogenic bladder dysfunction (NBD) are at
increased risk of urolithiasis. We review our experience with
percutaneous nephrolithotomy (PCNL) on this group of patients
with special attention paid to the risks of surgical complications.
Methods: A total of 18 cases with NBD underwent PCNL at our
institution. Neurogenous lesions included traumatic spinal cord
injuries in 8 cases, sequel of cerebrovascular accident in 2,
meningitis in 2, polio in 4 and kyphoscoliosis in 2. Percutaneous
access was achieved under fluoroscopic guidance with a patient
in the prone position and tract was formed using balloon
dilation system. Stone disintegration was accomplished with a
pneumatic lithotripter.
Results: There were 8 staghorn stones, 6 pelvi-calyceal stones,
and 4 isolated renal pelvic stones. The mean operation time was
97.5±18.7 (range: 80-120) minutes and the mean hospitalization
time was 3 (range: 2-5) days. Stone-free status was achieved in
13 (72.2%) renal units. 4 (22%) patients with 2 staghorn stones
and 2 pelvi-calyceal stones had clinically insignificant residual
fragments (CIRF). Hydropneumothorax was encountered in
1 case with kyphoscoliosis, in whom an intercostal access was
necessary.
Conclusion: PCNL in patients with NBD is safe and effective,
with outcomes comparable to that of patients without such a
disorder. (The Medical Bulletin of Haseki 2010; 48: 76-9) |
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ISSN: | 1302-0072 2147-2688 |