Percutaneous Nephrolithotomy Under X-Ray-Free Technique in Upper Urinary Stone Patients with Autosomal Dominant Polycystic Kidney Disease: Experience from a Large-Volume Stone Management Center.

Objectives

To present our large single-center experience in the management of autosomal dominant polycystic kidney disease (ADPKD) with total ultrasound (US)-guided percutaneous nephrolithotomy (PNL) and to evaluate the role of PNL under US in these patients. Patients and

Methods

We retrospectively reviewed the charts of patients with ADPKD who underwent PNL from August 2011 to December 2019. A total of 56 patients were included in this study; all procedures were completed by the total US-guided technique. Demographic characteristics, operative parameters, and postoperative data were collected and analyzed.

Results

Effective renal access was achieved in all patients. The mean stone size was 3.1 cm (range 1.7-6.5 cm). The initial stone-free rate was 70.6% (36/51); five patients underwent second-look PNL to remove residual stones. The other patients underwent oral medication therapy. No severe intraoperative complications occurred; one patient received selective embolization for bleeding on the contralateral side and one patient needed percutaneous drainage for perinephric abscess. Clavien I or II complications were seen in nine patients. Renal function was improved or stable in most patients; the condition of only one patient deteriorated after surgery.

Conclusion

Total US-guided PNL is a safe and efficient treatment for kidney stones in patients with ADPKD; perioperative renal function was not adversely affected and complications were acceptable compared with patients in the general population.