Percutaneous nephrolithotomy for the treatment of upper ureteral calculi with moderate or severe hydronephrosis

Objective To evaluate the clinical efficacy of percutaneous nephrolithotomy(PCNL) for the treatment of upper ureteral calculi with moderate or severe hydronephrosis.Methods We retrospectively investigated 239 cases(136 males,103 females) who underwent PCNL using pneumatic lithotripsy or holmium laser lithotripsy for upper ureteral calculi with moderate or severe hydronephrosis.The mean age was 45 years(range from 22 to 75 years).The stone located in the left side in 106 cases and 133 cases in the right side.56 of them accompanied with kidney calculi.Results The percutaneous access was established successfully under Btype ultrasound guidance and immediate phase one lithotripsy was performed in all patients.Average operation time was 40 minutes and average hospitalization duration was 5 days after operation.No severe complications such as pneumatothorax and organ injury occurred during the operation.Stone free rate was 100%.One case suffered from massive hemorrhage after the surgery.Conclusion PCNL with pneumatic or holmium laser and ultrasonic power under B-type ultrasound guidance is efficient and causes less complication,it is suitable for the treatment of upper ureteral calculi with moderate or severe hydronephrosis.