Factors Influencing the Success Rate of Percutaneous Nephroureterolithotripsy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Percutaneous nephroureterolithotripsy is one of alternative methods for the treatment of upper ureteral stones which are impacted in ureter or unresponsive to repeated extracorporeal shock wave lithotripsy(SWL). We evaluated the factors influencing the success rate of percutaneous nephroureterolithotripsy based on clinical data. MATERIALS AND METHODS: 107 patients(2 with bilateral) were included in this study. We reviewed the medical records and analyzed the factors ; stone size, laterality, location, site of percutaneous puncture, presence of pyuria, body weight, previous procedure(open surgery or SWL), and the experience of operator. RESULTS: The overall success rate of percutaneous nephroureterolithotripsy was 85.3%(93 of 109 cases). The location of stone and the experience of operator influenced the success rate of operation. The stones located above the lower pole level were obviously more successful than those located below it(57/62, 91.9% versus 36/47, 76.6%, p<0.05). In the late period of the operator`s experience, the success rate was significantly increased than that in the early period(51/58, 87.9% versus 40/51, 78.4%, p<0.05). But the stone size, laterality, site of percutaneous puncture, presence of pyuria, body weight and previous procedure didn`t influence the success rate. The average operation time was 93 minutes, average radiation exposure time was 2.2 minutes, and average hospital stay was 5.4 days. Most of the complications such as bleeding, urinary tract infection and pneumothorax were managed successfully with conservative treatments. CONCLUSIONS: Upper ureteral stones, which are impacted in ureter or unresponsive to repeated SWL can be successfully managed with percutaneous procedures. The stone location and the experience of operator are considered to be the major factors influencing the success rate.