Safety and efficacy of percutaneous nephrolithotomy in patients with neurogenic bladder
Copyright © 2022 Elsevier Masson SAS. All rights reserved..
INTRODUCTION: To assess the efficacy and morbidity of percutaneous nephrolithotomy (PNLT) in the treatment of renal stones in patients with neurogenic lower urinary tract dysfunction (NLUTD).
METHODS: Retrospective, monocentric study including all patients with NLUTD who had undergone PNLT between 2005 and 2017. Pre-operative clinical data (neurological condition, voiding mode, preoperative urine culture…), peri-operative and post-operative data (success and morbidity) were collected from the patients' charts. Success was defined by the absence of residual fragment (RF), on imaging or intraoperative endoscopy. Partial efficacy was defined by the presence of RF lower than 4mm. Early complications were reported according to the Clavien-Dindo classification.
RESULTS: In all, 53 PNLTs were performed, in 35 patients, mostly with spinal cord injury. The success and partial efficacy rates were 66.0% and 71.7% respectively. The failure rate was correlated with increased stone burden (P=0.03), increased size of the largest stone (P=0.02), and the presence of complex stones (P<0.02). The rate of early complications was 41.5%, with 27.3% major, mostly septic, and bleeding. The retreatment rate within 3 years was 41.5%.
CONCLUSION: In patients with NLUTD, PNLT allows a high success rate, but with a significant rate of retreatment and infectious complications. However, NLPC remains the gold standard in this population, especially for renal stones larger 20mm, allowing a higher success rate than ureteroscopy and a lower retreatment rate.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie - 32(2022), 6 vom: 09. Mai, Seite 442-450 |
| Sprache: |
Französisch |
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| Weiterer Titel: |
Néphrolithotomie percutanée chez les patients neurologiques : efficacité et morbidité à long terme |
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| Beteiligte Personen: |
Chelghaf, I [VerfasserIn] |
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| Links: |
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| Themen: |
Calcul rénal |
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| Anmerkungen: |
Date Completed 23.05.2022 Date Revised 23.05.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.purol.2021.12.006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM338101497 |
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| 245 | 1 | 0 | |a Safety and efficacy of percutaneous nephrolithotomy in patients with neurogenic bladder |
| 246 | 3 | 3 | |a Néphrolithotomie percutanée chez les patients neurologiques : efficacité et morbidité à long terme |
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| 500 | |a Date Completed 23.05.2022 | ||
| 500 | |a Date Revised 23.05.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a INTRODUCTION: To assess the efficacy and morbidity of percutaneous nephrolithotomy (PNLT) in the treatment of renal stones in patients with neurogenic lower urinary tract dysfunction (NLUTD) | ||
| 520 | |a METHODS: Retrospective, monocentric study including all patients with NLUTD who had undergone PNLT between 2005 and 2017. Pre-operative clinical data (neurological condition, voiding mode, preoperative urine culture…), peri-operative and post-operative data (success and morbidity) were collected from the patients' charts. Success was defined by the absence of residual fragment (RF), on imaging or intraoperative endoscopy. Partial efficacy was defined by the presence of RF lower than 4mm. Early complications were reported according to the Clavien-Dindo classification | ||
| 520 | |a RESULTS: In all, 53 PNLTs were performed, in 35 patients, mostly with spinal cord injury. The success and partial efficacy rates were 66.0% and 71.7% respectively. The failure rate was correlated with increased stone burden (P=0.03), increased size of the largest stone (P=0.02), and the presence of complex stones (P<0.02). The rate of early complications was 41.5%, with 27.3% major, mostly septic, and bleeding. The retreatment rate within 3 years was 41.5% | ||
| 520 | |a CONCLUSION: In patients with NLUTD, PNLT allows a high success rate, but with a significant rate of retreatment and infectious complications. However, NLPC remains the gold standard in this population, especially for renal stones larger 20mm, allowing a higher success rate than ureteroscopy and a lower retreatment rate | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Calcul rénal | |
| 650 | 4 | |a Lithiase | |
| 650 | 4 | |a Neurogenic bladder | |
| 650 | 4 | |a Néphrolithotomie percutanée | |
| 650 | 4 | |a Percutaneous nephrolithotomy | |
| 650 | 4 | |a Renal stone | |
| 650 | 4 | |a Sepsis urinaire | |
| 650 | 4 | |a Urinary tract infection | |
| 650 | 4 | |a Urolithiasis | |
| 650 | 4 | |a Vessie neurologique | |
| 700 | 1 | |a Glemain, P |e verfasserin |4 aut | |
| 700 | 1 | |a Madec, F X |e verfasserin |4 aut | |
| 700 | 1 | |a Loubersac, T |e verfasserin |4 aut | |
| 700 | 1 | |a de Vergie, S |e verfasserin |4 aut | |
| 700 | 1 | |a Branchereau, J |e verfasserin |4 aut | |
| 700 | 1 | |a Rigaud, J |e verfasserin |4 aut | |
| 700 | 1 | |a Perrouin-Verbe, B |e verfasserin |4 aut | |
| 700 | 1 | |a Lefort, M |e verfasserin |4 aut | |
| 700 | 1 | |a Perrouin-Verbe, M A |e verfasserin |4 aut | |
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