A.Ts. Borzhievsky, R.I. Payuk, R.Z. Sheremeta, Ts.K. Borzhievsky, M.M. Chaplya

Efficacy of the percutaneous nephrolithotripsy in the treatment of patients with the staghorn and large-volume nephrolithiasis of the duplex kidney

In this article results of the treatment of 42 patients with nephrolithiasis of the duplex kidney have been analyzed. The complete and incomplete kidney duplication was diagnosed in 12 (28.6%) and 30 (71.4%) patients respectively. PCNL was performed on the right duplex kidney in 27 (64.3%) patients and on the left duplex kidney in 15 (35.7%) patients. The surgery was more complicated in case of the duplex staghorn and large-volume nephrolithiasis in comparison with the ordinary staghorn and large-volume nephrolithiasis. After PCNL the kidneys were completely free from the stone in 32 (76.19%) patients. In 10 (23.81%) patients ESWL of the residual fragments after PCNL was performed. After that the kidney was completely cleared from the stone in 40 (95.24%) patients, residual fragments were remaining in the pelvis and cylices of the duplex kidney in 2 (4.76%) patients, when ESWL of the residual fragments had not been effective. The absolute indications for the operation in case of nephrolithiais of the duplex kidney are large staghorn renal stones (> 1.5 cm), obstructive complications of the nephrolithiais with chronic pyelonephritis and hypertension. Percutaneous nephrolithotripsy is highly effective and minimally invasive method of treatment of patients with duplex nephrolithiiasis, its efficacy as a monotherapy reaches 76.19%. Combination of PCNL and ESWL increases the efficacy of treatment up to 95.24%.