Percutaneous nephrolithotomy in horseshoe kidney: our 5-year experience

To review our 5-year experience in percutaneous nephrolithotomy (PCNL) for horseshoe kidney with large stone burden or failed shockwave lithotripsy (SWL). During 5 years (2006 to 2011), PCNL was performed on 21 patients with horseshoe kidney stone. We evaluated patients (age and gender), stones characteristics (size, number, side, and site), surgical technique, and outcomes. Sixteen (76.16%) subjects were men and 5 (23.80%) were women, with the mean age of 35 ± 12 years. Mean stone size was 37.2 ± 16.6 mm. Percutaneous nephrolithotomy was performed because of the stone size (over 20 mm) in 18 (85.68%) and failed SWL in 3 (14.28%) subjects. Stone numbers were more than one in 18 (85.68%) subjects, and were in the pelvis and at least one calyx. The most common access site was superior posterior calyx (66.64%). Stone-free rate with single session and rigid nephroscope was 71.40%. No major complication occurred during the surgery or in post surgical period. Postoperative minor complications occurred in 3 (14.28%) patients, including transfusion in one (4.76%), fever in one (4.76%), and ileus in one (4.76%) subject. Percutaneous nephrolithotomy has acceptable results in horseshoe kidney stone and is feasible with rigid nephroscope. Safety and efficacy of PCNL resembled the normal anatomy kidney in our study.