[Percutaneous nephrolithotomy of an upper pole calix stone in a transplanted kidney]

Mini-percutaneous nephrolithotomy via ultrasound guidance in transplanted kidney: a report of two cases

Urolithiasis is a rare but familiar problem in transplanted kidney patients, with a prevalence rate between 0.23-6.3%. Minimally invasive percutaneous nephrolithotomy (mini-PCNL) is a revised technique that uses a miniature endoscope through a small access sheath and is associated with minor bleeding risk. Only a few cases of mini-PCNL via ultrasonography (US) guidance in transplanted kidneys have been published. We present a 23-year-old female and a 34-year-old man who presented with obstructive uropathy due to impacted stones in their transplanted kidneys. Firstly, the nephrostomy tube was inserted. Then, they underwent mini-PCNL via US guidance. Puncturing the pyelocaliceal system was achieved via a 3.5 MHz US probe. Procedures were performed with a one-shot dilatation technique and a 15-Fr rigid nephroscope. In conclusion, we suggest that if an experienced urologist performs it, the US-guided mini-PCNL is safe and effective in patients with transplanted kidneys.

Mini-percutaneous nephrolithotomy with ureteral access sheath in a transplanted kidney: case report and literature review

This is the case of a 69-year-old woman with a history of right iliac fossa living-related kidney transplant that developed acute renal failure due to an obstructing stone in the proximal transplant ureter. She was successfully treated with mini-percutaneous nephrolithotomy wherein a 14-Fr tract was created with serial dilation and a 14-Fr ureteral access sheath was used for access. A flexible ureteroscope with holmium laser and a helical wire basket were used to fragment and extract the stone, respectively. A 10-Fr nephrostomy tube was left for postoperative drainage. There are only a few published reports of mini-percutaneous nephrolithotomy in transplant kidneys, but those reports suggest that the procedure is safe and effective.