Percutaneous Nephrolithotomy in Patients with or without a History of Open Nephrolithotomy

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Abstract
Background and Purpose: Whether a history of open nephrolithotomy affects the efficacy and morbidity of percutaneous interventions remains unsettled. We investigated this issue in our patients. Patients and Methods: A series of 51 men and 14 women who had undergone nephrolithotomy at least once (group A; mean age 40 years) were compared with 73 men and 44 women submitting to percutaneous nephrolithotomy (PCNL) as their first surgery (group B; mean age 43 years). All patients were operated on by the same surgeons over the same period of time. Fifty patients (81.5%) in group A harbored a single stone, whereas 35.9% of patients in group B had single stones (P < 0.001). However, the two groups were similar in terms of stone laterality, the right:left ratio being 1.03 in group A and 0.67 in group B (P = 0.22). Results: The proportion of patients in whom PCNL failed to clear all the stones even though access was obtained did not differ in the two groups (6.15% in group A and 8.55% in group B; P = 0.77). The collecting system was inaccessible in 6.2% and 5.1% of patients, respectively (P = 0.74). Pyelonephritis or abnormal bleeding occurred in similar proportions in the two groups (P = 0.72 and P = 0.74, respectively). No other surgical complications occurred in either group. Conclusion: A history of open nephrolithotomy does not adversely affect the efficacy or morbidity of PCNL.

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