Application of artificial hydronephrosis in percutaneous nephrostomy for the tre atment of complicated nephrolithiasis

Objective To evaluate the value of artifici al hydronephrosis in percutaneous nephrostomy for the treatment of complicated n ephrolithiasis without hydronephrosis. Methods Artificia l hydronephrosis was performed in 26 patients with complicated nephrolithiasis ( 18 men and 8 women;mean age,39 years;age range,19-67 years).Among them the calcu li were located on the left side in 12 cases,on the right in 10 and on both in 4 ;single staghorn calculus in 8 cases and multiple in 18.The mean diameter of the calculi was 3.8 cm (range,3.0-6.5 cm).Retro-ureteral cannulation was performed and normal saline was pumped into the pelvis and then artificial hydronephrosis was formed. And guided by B-ultrasound,minimally invasive percutaneous nephrol ithotomy (MPCNL) was carried out. Results The procedure was successful in 24 (92.3%) of the 26 cases and failed in 2.Guided by X-ray of pyelographic location,puncture was performed and succeeded in the 2 cases.Cathe ters for fistulization were placed on 28 sides (93.3%) of the patients. Intraope rative bleeding was 40-1200 ml.Six patients received blood transfusion. Conclusions Percutaneous nephrostomy guided by B-ultrasound aft er artificial hydronephrosis is an effective method for patients with complicate d nephrolithiasis without hydronephrosis.