Objectives: To analyze factors that can impact the intraoperative and postoperative complications and bleeding after percutaneous nephrolithotomy (PNL) in patients with a solitary kidney.
Material and Methods: A prospective hospital-based study that was carried out at the Urology Department, Sohag University Hospital from June 2017 to June 2019. All patients with renal calculi in a solitary kidney were recruited and underwent PNL.
Results: 150 patients were enrolled in this study. 93 (62%) patients were males while 57 (38%) patients were females. Initial SFR was achieved in 129 (86%) patients while residual fragments were reported in 21 (14%) patients. 39 (26%) patients had postoperative complications. On univariate analysis, the rate of complications was associated with the complexity of the stones, acute dilatation of the tract, and operative time (P-value = 0.048, 0.004 & 0.023 respectively). On the other hand; there was an association between the number of the accessed tracts and the rate of bleeding and blood transfusion (P-value = 0.008).
Conclusion: PNL in solitary kidneys is a challenging procedure; however high SFRs can be achieved with a low rate of significant complications. The complexity of the stones, acute dilatation of the tract, and prolonged operative time are associated with more complications. Multiple tracts have a significant effect on intraoperative bleeding. PNL should be considered by urologists as an effective therapeutic choice for patients presenting with large burden stone disease in a solitary kidney.