Percutaneous nephrolithotomy in horseshoe kidneys: factors affecting stone-free rate

• Published in: The Journal of urology Vol. 186; no. 5; p. 1894
• Main Authors: Skolarikos, Andreas, Binbay, Murat, Bisas, Apostolos, Sari, Erhan, Bourdoumis, Andrew, Tefekli, Ahmet, Muslumanoglu, Ahmet Yaser, Deliveliotis, Charalambos
• Format: Journal Article
• Language: English
• Published: United States 01-11-2011
• Subjects: Adult; Female; Humans; Kidney - abnormalities; Lithotripsy; Logistic Models; Male; Middle Aged; Nephrostomy, Percutaneous; Retrospective Studies
• ISSN: 1527-3792
• DOI: 10.1016/j.juro.2011.06.056

We report a 2-center study of factors affecting the stone-free rate after percutaneous nephrolithotomy in horseshoe kidneys.
The postoperative stone-free rate after percutaneous nephrolithotomy was evaluated in 47 male and 11 female patients with horseshoe kidneys. All data were collected prospectively. Patient and procedure related factors predicting the stone-free rate were analyzed by univariate and multivariate tests.
The mean ± SD stone burden was 7.62 ± 7.18 cm(2) (range 1 to 45) and the stone was larger than 10 cm(2) in 14 patients (24.1%). Complex stones and staghorn stones were present in 21 (36.2%) and 19 patients (32.7%), respectively. The overall stone-free rate was 65.5%. Complex stones (p = 0.01), stone burden greater than 5 cm(2) (p = 0.013), stone burden greater than 10 cm(2) (p = 0.012), multiple stones (p = 0.006) and staghorn stones (p <0.001) were related to adverse outcomes on univariate analysis. Logistic regression analysis revealed that staghorn calculi was the only factor that significantly predicted the stone-free rate (p = 0.002). A patient with staghorn calculi in the horseshoe kidney was 45 times more likely to have a lower stone-free rate after percutaneous nephrolithotomy than a patient without staghorn calculi in the horseshoe kidney.
Stone parameters are important when treating calculi in horseshoe kidneys. Staghorn calculi are associated with a lower stone-free rate after percutaneous nephrolithotomy.