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    Is retrograde intrarenal surgery successful in the treatment of stones in kidneys with anomalies?
    (2020) Gok, Bahri; Kamaci, Davut; Koc, Erdem; Asil, Erem; Atmaca, Ali Fuat; Odabas, Oner
    Aim: To evaluate the results of retrograde intrarenal surgery (RIRS) in stones with anomaly in the kidney.Material and Methods: Between April 2016 and November 2018, the data of 350 patients undergoing retrograde intrarenal surgery due to kidney stones were retrospectively examined.Patients with stones in the kidney with anomalies were recorded. Demographic data, localization of the stone, size, and success and complication rates were reviewed.In the post-operative controls, stones that were 2 mm and below were accepted as stone-free.Postoperative success was evaluated as stone-free at the 1st and 3rd months.Results: The mean age of the patients was 50.9 ± 15.8 (20-78).RIRS was performed in 29 kidneys with anomalies.Ten patients had horseshoe kidneys, 2 patients had ectopic pelvic kidneys, 13 patients had double collecting system and 4 patients had rotation anomalies.The mean stone size was 16.3 ± 6.1 (8-30) mm. The postoperative 1st and 3rd month stone-free rate was 48.2% and 51.7%, respectively.The complication developed in 4 (13.7%) patients. All of these were minor complications.Second procedure was applied to 14 of the remaining patients. Conclusion: In the treatment of kidney stones with anomalies, RIRS is reliable with low complication rates, but the patient should be informed about the need for additional procedures due to low stone-free rates.
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    Laparoscopic pyelolithotomy/ureterolithotomy combined with flexible ureterorenoscopy for upper urinary tract stones especially in anomalous kidneys
    (2020) Olcucuoglu, Erkan; Olcucu, Mahmut Taha; Tonyali, Senol; Olcucuoglu, Esin; Odabas, Oner
    Aim: To determine the feasibility and efficacy of combining laparoscopy with flexible ureteroscopy to achieve stone free status especially in patients having large pelvic renal stones in their anomalous urinary tract.Material and Methods: We retrospectively reviewed the medical records of all patients who underwent laparoscopic pyelo/uretero- lithotomy in our clinic between March 2013 and December 2017.Results: A total of 24 patients were included the study. The mean age of the patients was 49.7 years ranging from 20 to 75 years. Pyelolithotomy was performed in 17 cases and ureterolithotomy was performed in 7 cases. The mean size of the main upper urinary tract stones (pelvis and upper ureter) was 40 mm and the mean size of the concomitant stones (renal pelvis and calices) was 8.5 mm. Of the pyelolithotomy patients, six had ureteropelvic junction (UPJ) obstruction, seven had a horseshoe kidney and one had a pelvic kidney abnormality. Pyeloplasty was performed concomitant with stone surgery in patients with UPJ obstruction. The mean operative time was 122 min. Estimated blood loss was 55 ml. Stone - free status was 91.6%. There was no intraoperative complication. The mean hospital stay of the patients was 4 days.Conclusion: Laparoscopic pyelolithotomy/ureterolithotomy combined with flexible endoscopy (cystoscope) for renal pelvis and caliceal stones is a safe and effective procedure to achieve stone free status especially in patients having congenital anomalous kidneys.