Percutaneous Nephrolithotomy and Horseshoe Kidneys

• Main Authors: Robin Bahadur Basnet, Anil Shrestha, Parash Mani Shrestha, Biswa Raj Joshi
• Format: Article
• Language: English
• Published: HEAD Nepal 2020-12-01
• Series: Nepalese Medical Journal
• Subjects: complications; horseshoe kidney; percutaneous nephrolithotomy; stone clearance
• Online Access: https://www.nepjol.info/index.php/nmj/article/view/33032

Introduction: The most common fusion anomaly, horseshoe kidney, is associated with vascular anomalies, malrotation, anterior displacement of the collecting system, superior insertion of ureter into the pelvis, and a higher rate of ureteropelvic junction obstruction; thus increasing the chances of nephrolithiasis. We present our experience with percutaneous nephrolithotomy in this anomaly. Materials and Methods: A retrospective study of all the percutaneous nephrolithotomy performed by standard technique within four years at Bir Hospital was made. A comparison was made with similar cases with the anatomically normal location of the kidney. Intraoperative variables were recorded and postoperative stonefree status and complications were evaluated. Results: Six hundred and twenty-seven patients out of 691 who had undergone percutaneous nephrolithotomy in this period were included. Patients with nephrolithiasis in horseshoe kidney were younger, the incidence of multiple stones was more; without full staghorn calculus and occupying fewer calyces. Upper pole access was easier, a stone clearance of 85.42 % was achieved with no major complications in the horseshoe kidney. Conclusions: Percutaneous access and nephrolithotomy are safe in horseshoe kidney with a good stone clearance rate.