Application of articial hydronephrosis in percutaneous nephrolithotripsy under B-type ultrasound guidance for treatment of renal calculi without hydronephrosis

【Objective】To evaluate the efficacy and safety of management of renal stone in non-dilated collecting system by percutaneous nephrolithotripsy (PCNL) under ultrasound guidance.【Method】From August 2008 to April 2009, 9 cases of renal stone (7 men and 2 women;mean age, 42 years; age range, 35～72 years) in non-dilated collecting system were performed by percutaneous nephrolithotripsy. Among them the calculi were located on the left side in 6 cases, on the right in 3 cases; single in 4 cases, staghorn calculus in 3 cases and multiple in 2. The mean diameter of the calculi was 3.5 cm (range, 2.0～4.5 cm). A stent can not be inserted into the pelvis through cystoscope. Furosemide was injected intravenously after a catheter was inserted into bladder and saline was instilled to dilate collecting system. Antegrade percutaneous access was obtained by B-type ultrasound guidance. A ultrasonic lithotrite was used to disintegrate and remove stone under direct vision. 【Results】The percutaneous renal access was successfully established under B-type ultrasound guidance in all patients, immediate phaseⅠlithotripsy was performed in 9 cases. Operation time of the percutaneous renal access ranged from 10 to 25 minutes, average timewas 16 minutes. Intraoperative bleeding was 150 (40～400) mL. None of cases was surpported by blood transfusion, se- vere complications did not occur during nephrolithotripsy.【Conclusion】The management of renal stone in non-dilated collecting system using PCNL appears to be efficacious and safe under B-type ultrasound guidance.