Safety and efficacy of PNL vs RIRS in the management of stones located in horseshoe kidneys: A critical comparative evaluation

  • Bilal Eryildirim | bilaleryildirim@yahoo.com Health Sciences University, Dr. Lütfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Eyup Veli Kucuk Health Sciences University, Umraniye Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Gokhan Atis Istanbul Medeniyet University, Goztepe Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Metin Ozturk Health Sciences University, Haydarpasa Numune Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Temucin Senkul Health Sciences University, Sultan Abdulhamid Han Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Murat Tuncer Health Sciences University, Dr. Lütfi Kirdar Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Ahmet Tahra Health Sciences University, Umraniye Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Turgay Turan Istanbul Medeniyet University, Goztepe Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Orhan Koca Health Sciences University, Haydarpasa Numune Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Ferhat Ates Health Sciences University, Sultan Abdulhamid Han Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Omer Yilmaz Health Sciences University, Sultan Abdulhamid Han Training and Research Hospital, Urology Clinic, Istanbul, Turkey.
  • Cenk Gurbuz Medistate Hospital, Urology Department, Istanbul, Turkey.
  • Kemal Sarica Kafkas University, Faculty of Medicine, Urology Department, Turkey.

Abstract

Aim: To assess the efficacy and safety of two different techniques (Percutaneous nephrolithotomy (PNL) vs Retrograde intrarenal surgery (RIRS)) in the management of stones in patients with horseshoe kidneys (HSK). Patients and methods: Departmental files of 88 cases with radiopaque kidney stones in horseshoe kidneys undergoing two different approaches (PNL vs RIRS) were evaluated with respect to the success and complication rates of in a retrospective manner. In addition to the factors related with the procedures (success and complication rates, additional procedures), patient and stone characteristics were all well evaluated. Findings obtained in both groups were evaluated in a comparative manner with respect to the statistical significance. Results: Stone free rates were comparable in both groups after 1-week period (81.6% PNL vs 80% RIRS). As well as 3 months evaluation (84.2% PNL and 82.0% RIRS). The percentage of the cases with residual fragments (> 4 mm) were similar in both groups and while all PNL procedures were completed in one session, mean number of RIRS sessions was higher (1.22 ± 0.05). Mean duration of the procedure was slightly higher in RIRS group and based on Clavien scoring system, despite a higher risk of Hb drop noted in patients treated with PNL, all complication rates were found to be similar in both groups. Conclusion: Our results demonstrate that of the available minimally invasive treatment alternatives, both PNL and RIRS could be safe and effective alternatives for renal stone removal in patients with HSK.

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Published
2018-09-30
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Issue
Section
Original Papers - Stones and Infections
Keywords:
Horseshoe kidney, Percutaneous nephrolithotomy, Retrograde intrarenal surgery, Renal stone, Ureteroscopy.
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How to Cite
Eryildirim, B., Kucuk, E. V., Atis, G., Ozturk, M., Senkul, T., Tuncer, M., Tahra, A., Turan, T., Koca, O., Ates, F., Yilmaz, O., Gurbuz, C., & Sarica, K. (2018). Safety and efficacy of PNL vs RIRS in the management of stones located in horseshoe kidneys: A critical comparative evaluation. Archivio Italiano Di Urologia E Andrologia, 90(3), 149-154. https://doi.org/10.4081/aiua.2018.3.149