Outcomes of Percutaneous Nephrolithotomy in Horseshoe Kidneys: A retrospective cohort study from a single centre in South India

Abstract

Introduction

This study was undertaken to evaluate the outcomes and safety profile of percutaneous nephrolithotomy (PCNL) in HSK patients.

Materials and Methods

Between 2019 and 2024, individuals with stones in HSKs who received PCNL treatment at our institution were retrospectively reviewed.

Results

Between 2019 and 2024, 29 HSKs with stones underwent PCNL treatment at our institution. 39.9 ± 14.95 years was the average age. The mean body mass index (BMI) was 22.9 ± 4.5 kg/m2. The mean stone size was 25.07 ± 0.8mm. Calyceal access was obtained through the upper pole in 17 patients (58.6%), the inter pole in 10 patients (34.5%), and the lower pole in five patients (17.2%). A flexible nephroscope was done in four patients (13.8%). Postoperative complications occurred in five patients (17.2%) with Clavien Dindo scores less than three and one patient (3.4%) with a Clavien Dindo score of three.

The success rate following a single session of PCNL was 62%, with seven patients (24.1%) requiring ancillary procedures. After these additional interventions, the overall success rate increased to 86.2%. Analysis of variables affecting stone-free rates after PCNL in HSKs with stones revealed a direct correlation with stone size (p-value 0.04).

Conclusion

Our experience with percutaneous nephrolithotomy in horseshoe kidneys showed a comparable stone-free rate (86.2%) with no occurrence of significant complications. Although stone-free status is less affected by demographic and operative parameters, stone size played an important role in achieving stone-free status in this single-center analysis.

List Of Abbreviations

• HSK – Horseshoe kidney
• PCNL – Percutaneous Nephrolithotomy
• Fr – French
• BMI – Body Mass Index
• SD – Standard deviation
• IQR – Interquartile range
• SWL – Shock Wave Lithotripsy