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Outcome of ureteroscopy for stone disease in patients with horseshoe kidney: Review of world literature

Outcome of ureteroscopy for stone disease in patients with horseshoe kidney: Review of world literature
Outcome of ureteroscopy for stone disease in patients with horseshoe kidney: Review of world literature

INTRODUCTION AND OBJECTIVES: The management of urolithiasis in patients with horseshoe kidney (HSK) is difficult. Stone formation occurred in 1:5 patients with HSK due to impaired urinary drainage and infections. Percutaneous nephrolithotomy and shock wave lithotripsy can be technically challenging due to altered anatomy.

MATERIALS AND METHODS: We conducted a systematic review of the literature to look at the role of ureteroscopy for stone management in these patients. We searched MEDLINE, PubMed and the Cochrane Library from January 1990 to April 2013 for results of ureteroscopy and stone treatment in HSK patients. Inclusion criteria were all English language articles reporting on ureteroscopy in patients with HSK. Data were extracted on the outcomes and complications.

RESULTS: A total of 3 studies was identified during this period. Forty-one patients with HSK underwent flexible ureteroscopy and stone treatment. The mean age was 42 with a male:female ratio nearly 3:1. The mean stone size was 16 mm (range: 3-35 mm). The mean operating time was 86 min with multiple stones seen in 15 patients. All 41 patients had a ureteral access sheath used and flexible ureteroscopy and holmium laser fragmentation done. Thirty-two (78%) patients were stone-free with a mean hospital stay of 1-day. Minor complications (Clavien I or II) were seen in 13 (32%) of which 6 had stent discomfort, 3 needed intravenous antibiotics for <24 h, 3 had hematuria of which 2 needed blood transfusion and one had pyelonephritis needing re-admission and antibiotics. There were no major complications found in the review.

CONCLUSIONS: Retrograde stone treatment using ureteroscopy and lasertripsy in HSK patients can be performed with good stone clearance rate, but with a slightly higher complication rate. This procedure should, therefore, be done in high volume stone center with an experienced stone surgeon/team.

Journal Article
2090-5998
470-474
Ishii, Hiro
d2dd0ce3-0ccd-4cb4-8aa1-f6d363e29b90
Rai, Bhavan
e1156207-bfd1-4f89-b0aa-9e55fc54235b
Traxer, Olivier
2fa78817-b6f8-4f00-b389-c9c9ddbd01f3
Kata, Slawomir G.
bb011d0d-01f0-4c99-ac40-e8db8d4ef4d0
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Ishii, Hiro
d2dd0ce3-0ccd-4cb4-8aa1-f6d363e29b90
Rai, Bhavan
e1156207-bfd1-4f89-b0aa-9e55fc54235b
Traxer, Olivier
2fa78817-b6f8-4f00-b389-c9c9ddbd01f3
Kata, Slawomir G.
bb011d0d-01f0-4c99-ac40-e8db8d4ef4d0
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Ishii, Hiro, Rai, Bhavan, Traxer, Olivier, Kata, Slawomir G. and Somani, Bhaskar K. (2015) Outcome of ureteroscopy for stone disease in patients with horseshoe kidney: Review of world literature. Arab Journal of Urology, 7 (4), 470-474. (doi:10.4103/0974-7796.157969).

Record type: Article

Abstract

INTRODUCTION AND OBJECTIVES: The management of urolithiasis in patients with horseshoe kidney (HSK) is difficult. Stone formation occurred in 1:5 patients with HSK due to impaired urinary drainage and infections. Percutaneous nephrolithotomy and shock wave lithotripsy can be technically challenging due to altered anatomy.

MATERIALS AND METHODS: We conducted a systematic review of the literature to look at the role of ureteroscopy for stone management in these patients. We searched MEDLINE, PubMed and the Cochrane Library from January 1990 to April 2013 for results of ureteroscopy and stone treatment in HSK patients. Inclusion criteria were all English language articles reporting on ureteroscopy in patients with HSK. Data were extracted on the outcomes and complications.

RESULTS: A total of 3 studies was identified during this period. Forty-one patients with HSK underwent flexible ureteroscopy and stone treatment. The mean age was 42 with a male:female ratio nearly 3:1. The mean stone size was 16 mm (range: 3-35 mm). The mean operating time was 86 min with multiple stones seen in 15 patients. All 41 patients had a ureteral access sheath used and flexible ureteroscopy and holmium laser fragmentation done. Thirty-two (78%) patients were stone-free with a mean hospital stay of 1-day. Minor complications (Clavien I or II) were seen in 13 (32%) of which 6 had stent discomfort, 3 needed intravenous antibiotics for <24 h, 3 had hematuria of which 2 needed blood transfusion and one had pyelonephritis needing re-admission and antibiotics. There were no major complications found in the review.

CONCLUSIONS: Retrograde stone treatment using ureteroscopy and lasertripsy in HSK patients can be performed with good stone clearance rate, but with a slightly higher complication rate. This procedure should, therefore, be done in high volume stone center with an experienced stone surgeon/team.

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More information

Accepted/In Press date: 4 August 2014
e-pub ahead of print date: 14 October 2015
Published date: 23 December 2015
Keywords: Journal Article

Identifiers

Local EPrints ID: 419376
URI: http://eprints.soton.ac.uk/id/eprint/419376
ISSN: 2090-5998
PURE UUID: 20b9a779-0e8a-4aad-975b-e6438ddf5619

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Date deposited: 11 Apr 2018 16:30
Last modified: 20 Mar 2020 17:31

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