Efficacy of percutaneous nephrolithotomy of upper urinary stones after failed extracorporeal shock-wave lithotripsy treatment

Objective To investigate the efficacy and safety of percutaneous nephrolithotomy in patients with upper urinary calculi after failed ESWL. Methods A group of 26 cases, 19 males and 7 females, aging from 25 to 67 years with calculi diameter from 1 cm to 2.5 cm and previous ESWL history underwent percutaneous ultrasounic or pneumatic nephrolithotomy. Ureteroscopic lithotripsy was used for cases with lower ureteral calculi. Results All patients had successfully established single channel in 6 to 17 min. Calculi dealing time ranged from 20 min to 105 min. The blood loss ranged from 10 ml to 30 ml. Isolated calculi were found in 7 sides. In the other 25 sides all calculi were wrapped by varying degrees inflammatory polyps parcel, with some calculi adhering to the ureteral wall. Six cases had accumulation of matrix components in the center of calculi. The stone free rate was 75%(24/32), while no clinical significance stone residual rate was 25%(8/32). Conclusion Percutaneous nephrolithotomy was effective for upper urinary stones failed in ESWL.