Safety and efficacy of percutaneous nephrolithotomy in patients with single functioning kidney compared to patients with bilateral functioning kidneys

Background: Renal stones for patients with single functioning kidney are considered as great challenge facing the urologists. Different stone treatment modalities are used for single functioning kidney like shock wave lithotripsy, retrograde intra-renal surgery and percutaneous nephrolithotomy (PCNL).       

Objectives: This study aimed to compare the effectiveness and safety outcomes of PCNL in patients with single functioning kidney in comparison to PCNL outcomes in patients with bilateral functioning kidneys.

Methods: A prospective comparative study conducted in Urology department of Safeer Al-Imam Al-Hussein hospital in Karbala city-Iraq through the period from 1^st of March, 2015 to 30^th of September, 2018 on sample of 173 patients with renal stones surgically operated with PCNL categorized into two groups; group I included 51 patients with single functioning kidney and group II included 122 patients with bilateral functioning kidneys. The preoperative, operative and postoperative characteristics of patients were assessed by the researcher.  

Results: Mean age of group I patients was 42.76 years which was significantly higher than mean age of group II patients of 36.54 years (p=0.01). No significant differences were observed between group I and group II patients regarding patients gender, pre and intraoperative characteristics. The PCNL postoperative stone clearance, bleeding, renal function, organ injury and sepsis were not significantly different between group I and group II patients.     

Conclusion: The percutaneous nephrolithotomy is effective and safe surgical procedure for treatment of renal stones of patients with single functioning kidney.