Category: Clinical Stones: PCNL

MP32-18 - Percutaneous nephrolithotomy in previously operated kidneys: a comparison study by type of previous operation

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

Anatomical changes, perinephric scars and regional fibrosis related to previous renal operations may potentially affect the normal course of percutaneous nephrolithotomy (PCNL). This study assesses performance and outcome of PCNL by type of previous ipsilateral renal surgery.  


Methods :

A retrospective analysis of 860 PCNLs performed in the period 2005-2017 revealed 127 (15%) operations done after either a previous PCNL (N=67; 53) or a previous nephrolithotomy (N=60; 47%). These groups were statistically compared in terms of demographics, clinical data, intraoperative course and outcome. 


Results : The results are presented in the table. 


Conclusions :

In comparison to primary PCNL, PCNL in previously operated kidneys is associated with statistically significant larger and more complex stones on presentation and need for higher rates of multiple accesses. It results in statistically significant higher complications rates and lower stone free rates. Patients with prior open renal surgery were statistically significant older, had less tubeless procedures and their operations resulted in lower stone-free rate. This study may contribute in a proper patient consultation and preoperative planning. 

Yazeed Barghouthy

Resident in Urology
Department of Urology, Tel-Aviv Sourasky Medical Center
Tel-Aviv, Tel Aviv, Israel

Dekalo Snir

Resident in Urology
Department of Urology, Tel-Aviv Sourasky Medical Center
Tel-Aviv, Tel Aviv, Israel

Vasileios Kourmpetis

Fellow in Endourology
Endourology Unit, Tel-Aviv Sourasky Medical Center
Tel-Aviv, Tel Aviv, Israel

Avi Beri

Attending Urologist
Department of Urology, Tel-Aviv Sourasky Medical Center
Tel-Aviv, Tel Aviv, Israel

Mario Sofer

Director of Endourology Unit
Department of Urology, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University
Tel-Aviv, Tel Aviv, Israel