Residual Fragments after Percutaneous Nephrolithotomy

Year 2012, Volume: 2012 Issue: 3, 230 - 235, 01.03.2012

Kaan Özdedeli Mete Çek

https://doi.org/10.5152/balkanmedj.2012.082

Abstract

Clinically insignificant residual fragments (CIRFs) are described as asymptomatic, noninfectious and nonobstructive stone fragments (≤4 mm) remaining in the urinary system after the last session of any intervention (ESWL, URS or PCNL) for urinary stones. Their insignificance is questionable since CIRFs could eventually become significant, as their presence may result in recurrent stone growth and they may cause pain and infection due to urinary obstruction. They may become the source of persistent infections and a significant portion of the patients will have a stone-related event, requiring auxilliary interventions. CT seems to be the ultimate choice of assessment. Although there is no concensus about the timing, recent data suggests that it may be performed one month after the procedure. However, imaging can be done in the immediate postoperative period, if there are no tubes blurring the assessment. There is some evidence indicating that selective medical therapy may have an impact on decreasing stone formation rates. Retrograde intrarenal surgery, with its minimally invasive nature, seems to be the best way to deal with residual fragments.

Keywords

Nephrolithotomy, percutaneous, urinary stones

Residual Fragments after Percutaneous Nephrolithotomy

Abstract

References

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