Role of ultrasonography in percutaneous renal access in patients with renal anatomic abnormalities

Urology. 2013 May;81(5):938-42. doi: 10.1016/j.urology.2013.01.038. Epub 2013 Mar 6.


Objective: To present our experience regarding the feasibility, safety, and efficacy of ultrasound (US)-guided percutaneous nephrolithotomy in anatomically abnormal kidneys.

Materials and methods: We performed US-guided percutaneous nephrolithotomy in 15 patients with anatomically abnormal kidneys and renal calculi. Of the 15 patients, 5 had horseshoe kidneys, 5 had rotation anomalies, 2 had kyphoscoliosis, and 3 had scoliosis. The stone size, number of access tracts, operative time, hospitalization duration, rate of stone clearance, and complication rate were recorded. Percutaneous access was achieved with US guidance in the operating room by the urologist.

Results: Successful renal access was obtained by the surgeon using US guidance in all patients, and a single access was obtained in all cases. Of the 15 patients, 8 were females, and 7 were males; 8 patients had solitary stones, and 7 had multiple calculi. The renal calculi were on the right in 7 patients and on the left in 8. Three patients had previously undergone unsuccessful shock wave lithotripsy. Complete stone clearance was achieved in 13 patients. The mean operative time was 54.2 minutes. No patient required a blood transfusion because of bleeding. Urinary tract infections occurred in 2 patients, who were treated with antibiotics. A double-J catheter was not inserted in any patient; however, a ureteral catheter was used in 3 patients for 1 day. None of the patients had any major complications during the postoperative period. The stone-free rate was 87%, and 2 patients had clinically insignificant residual fragments.

Conclusion: Our results have demonstrated that US-guided percutaneous nephrolithotomy can be performed feasibly, safely, and effectively in anatomically abnormal kidneys.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Kidney / abnormalities*
  • Kidney / diagnostic imaging
  • Kidney / surgery
  • Kidney Calculi / diagnostic imaging*
  • Kidney Calculi / surgery*
  • Male
  • Middle Aged
  • Nephrostomy, Percutaneous / methods*
  • Retrospective Studies
  • Ultrasonography
  • Ureteroscopy / methods
  • Young Adult