Preoperative Evaluation of Living Renal Transplant Donors: Comparison of Contrast Enhanced Magnetic Resonance Angiography and Conventional Renal Angiography / 대한비뇨기과학회지

PURPOSE: This study was designed to compare conventional renal and contrast enhanced magnetic resonance angiography (CRA & CE-MRA, respectively) for the preoperative evaluation of living renal transplant donors. MATERIALS AND METHODS: Between September 2002 and November 2004, forty-five consecutive live renal transplant donors underwent preoperative evaluations of the renal vessels, using both CRA and CE-MRA before the donor nephrectomy. The intraoperative findings of the number of renal vessels were compared with those of CRA and CE-MRA, respectively. RESULTS: Both angiographic modalities were able to detect multiple renal arteries and veins, with overall agreement between CRA and CE-MRA of 97.8 and 97.8%, respectively. The overall accuracies for predicting the number of renal arteries and veins, relative to the intraoperative findings, were 91.1 and 91.1% for CRA and 88.9 and 95.6% for CE-MRA, respectively. The CE-MRA missed 5 accessory renal arteries, whereas CRA missed 4 cases. Despite the undetected cases, there was no significant intraoperative morbidity. Additionally, renal cysts seen on CE-MRA were not detected by CRA. CONCLUSIONS: Our findings suggest that noninvasive CE-MRA is a promising substitute for CRA to evaluate the renal vessels of live renal transplant donors.

Intrarenal Epidermal Cyst / 대한비뇨기과학회지

Epidermal cysts are benign cysts, which rarely localize in solid organs, but have an unclear pathogenesis. Herein, a case of an intrarenal epidermal cyst, in a 60-year-old woman with right flank pain, is reported. Multiple renal stones in the right kidney were identified by an intravenous pyelogram. A percutaneous nephrolithotomy (PCNL) was performed under the assumption of renal stones. Amorphorous cysts, containing calcification, were identified during the PCNL, which were histologically identical in appearance to an epidermal cyst within the skin. We suspected the pathogenetic mechanism of this lesion was a metaplasia of traumatic origin, due to the patient's history of renal stones, which had been previously treated with an open nephrolithotomy. According to the literature, an intrarenal epidermal cyst was usually treated by nephrectomy, under the assumption of a renal mass. Although the intrarenal epidermal cyst was incidentally found during the PCNL, an additional nephrectomy was not performed as it had almost been removed.

Intrarenal Epidermal Cyst / 대한비뇨기과학회지

Epidermal cysts are benign cysts, which rarely localize in solid organs, but have an unclear pathogenesis. Herein, a case of an intrarenal epidermal cyst, in a 60-year-old woman with right flank pain, is reported. Multiple renal stones in the right kidney were identified by an intravenous pyelogram. A percutaneous nephrolithotomy (PCNL) was performed under the assumption of renal stones. Amorphorous cysts, containing calcification, were identified during the PCNL, which were histologically identical in appearance to an epidermal cyst within the skin. We suspected the pathogenetic mechanism of this lesion was a metaplasia of traumatic origin, due to the patient's history of renal stones, which had been previously treated with an open nephrolithotomy. According to the literature, an intrarenal epidermal cyst was usually treated by nephrectomy, under the assumption of a renal mass. Although the intrarenal epidermal cyst was incidentally found during the PCNL, an additional nephrectomy was not performed as it had almost been removed.

Comparison of Renal Hemorrahge According to Technique of Percutaneous Tract Dilation in Percutaneous Nephrolithotomy / 대한비뇨기과학회지

Purpose: The incidence of renal hemorrhage and the transfusion rates in patients undergoing balloon or Amplatz fascial dilation of the nephrostomy tract during percutaneous nephrolithotomy (PCNL) were compared. Materials and Methods: The medical records of 100 patients who underwent PCNL were reviewed. The nephrostomy tract was dilated with either a balloon (53 patients) or Amplatz sequential (47 patients) dilators. The time required for nephrostomy tract dilation, the stone burden, perioperative blood hemoglobin level and blood transfusion rates were compared between the two groups. Results: Of the 47 patients that underwent percutaneous renal Amplatz dilatation, 14 (29%) required a blood transfusion, compared to only 7 of the 53 (13%) that underwent balloon dilation. The difference in the transfusion rates between the 2 groups was statistically significant (p=0.04). The time required for nephrostomy tract dilation was also shorter with balloon than Amplatz dilation (6.5 versus 12.3 minutes, p=0.02). Conclusions: Balloon dilation led to less renal hemorrhage and lower transfusion rates compared to Amplatz dilation during PCNL. Additionally, the time required for nephrostomy tract dilation was shorter with balloon dilation.)