Staghorn stones occur more frequently in case of struvite (magnesium ammonium phosphate), which linked to recurring urinary tract infections by urease-producing microorganisms. Percutaneous Nephrolithotomy (PCNL) remains the primary suggested treatment option of staghorn recurrent stones.Three standard dilation instruments are available: Amplatzfascial dilators, metal telescopic dilators, and balloon dilators. Serial dilation with the Amplatz set or metal telescopic dilators both require longer fluoroscopy and operating time. One-shot dilation has been shown to be safe and effective even in patients with a history of open renal surgerywith decreased fluoroscopy and operative time.The main goals with either approach would be a complete stone free rate withthe least amount of morbidity.
Aim of the work:
The aim of this work was to compare single step dilation and sequential Alken metal renal dilation during percutaneous nephrolithotomy for management of recurrent staghorn renal stones.
Patients and Methods:
This prospective study was conducted from January 2022 to May 2023 on 100 adult patients who presented to the department of Genitourinary Surgery at Alexandria Main University Hospital with recurrent staghorn renal stones and were eligible for PCNL treatment.Patients were randomly assigned by simple randomization method to group A (50 patients: single-step renal dilatation) and group B (50 patients: serial metal Alken renal dilatation).Intra-and post-operative data were recorded with primary study endpoints: “operative time and fluoroscopy exposure time" and secondaryendpoints: “complications (need for blood transfusion, Hb drop, etc..) and hospital stay."