ahmed nahas | South Valley (original) (raw)

Conference Presentations by ahmed nahas

Research on Allianz Arena Stadium

Official FC Bayern Munchen Website

Papers by ahmed nahas

Journal of endourology / Endourological Society, 2005

It is rare for hydatid disease to be encountered primarily in the urogenital system or retroperit... more It is rare for hydatid disease to be encountered primarily in the urogenital system or retroperitoneum. Moreover, prostatic involvement is extremely rare. We present a case report of prostatic hydatid cyst that was treated with laparoscopic excision. We reviewed diagnosis and management of hydatid disease of the urogenital tract.

Abstract Objectives: To present treatments for kidney preservation in the management of emphysema... more Abstract Objectives: To present treatments for kidney preservation in the management of emphysematous pyelonephritis (EPN), and to evaluate the functional outcome of preserved kidneys during the follow-up. Patients and methods: The computerized files of patients with EPN from 2000 to 2010 were reviewed. After initial resuscitation, ultrasonography-guided percutaneous tubes were placed for drainage of infected fluid and gas. A radio-isotopic renal scan was done after stabilization of the patients’ condition. Preservation of the affected kidney was attempted when the differential function was >10%. A renal isotopic scan was taken during the follow-up to evaluate renographic changes in preserved kidneys. Results: The study included 33 kidneys in 30 consecutive patients (mean age 51.7 years, SD 10.9). Kidney preservation was applicable for 23 kidneys (20 patients). Preservation methods included percutaneous nephrostomy for 12, percutaneous tube drain for two and conservative treatmen...

The Journal of Urology, 2015

We compared outcomes of percutaneous nephrolithotomy and retrograde intrarenal surgery in the tre... more We compared outcomes of percutaneous nephrolithotomy and retrograde intrarenal surgery in the treatment of children with renal calculi larger than 2 cm. A total of 38 patients younger than 16 years with renal calculi larger than 2 cm were randomized to undergo percutaneous nephrolithotomy or retrograde intrarenal surgery between May 2011 and February 2014. Demographic data, stone criteria, operative technique, radiation time, complications, blood transfusion, hemoglobin decrease, stone-free rate and length of hospital stay were compared between the groups. Stone-free status was documented if there were no residual stones after 1 month. The study included 43 renal units, of which 21 were subjected to retrograde intrarenal surgery and 22 to percutaneous nephrolithotomy. Operative time was comparable for both groups. Mean radiation time and hospital stay were longer after percutaneous nephrolithotomy (p <0.001). Stone-free rate was significantly lower after retrograde intrarenal surgery monotherapy vs percutaneous nephrolithotomy monotherapy (71% vs 95.5%, p = 0.046). Patients in the percutaneous nephrolithotomy group had significantly more complications compared to the retrograde intrarenal surgery group (p = 0.018). Three patients in the percutaneous nephrolithotomy group received blood transfusions, compared to none in the retrograde intrarenal surgery group (p = 0.015). For treatment of large or complex renal stones in pediatric patients percutaneous nephrolithotomy monotherapy has the advantage of better stone-free rates, while retrograde intrarenal surgery has the advantages of decreased radiation exposure, fewer complications and shorter hospital stay.

Arab Journal of Urology, 2015

Objective: To compare the efficacy, safety and cost of extracorporeal shockwave lithotripsy (ESWL... more Objective: To compare the efficacy, safety and cost of extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL) for treating a 20-30 mm single renal pelvic stone.

The Journal of Urology, 2015

The Journal of Urology, 2015

TSW Urology, 2006

The first-line management of renal stones between 20-30 mm remains controversial. The Extracorpor... more The first-line management of renal stones between 20-30 mm remains controversial. The Extracorporeal Shock Wave Lithotripsy (ESWL) stone-free rates for such patient groups vary widely. The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL in such controversial groups.

The Journal of Urology, 2014

We studied acute renal morphological and hemodynamic changes after shock wave lithotripsy of rena... more We studied acute renal morphological and hemodynamic changes after shock wave lithotripsy of renal stones. A total of 60 adult patients with a single renal stone 25 mm or less in a radiologically normal urinary tract were eligible for shock wave lithotripsy and included in analysis. Study exclusion criteria were hypertension, diabetes mellitus, previous recent stone management and other contraindications to shock wave lithotripsy. Renal perfusion and morphological changes were evaluated by dynamic magnetic resonance imaging before, and 2 to 4 hours and 1 week after lithotripsy. In all cases there was a statistically significant decrease in renal perfusion 1 week after shock wave lithotripsy compared to before and 2 to 4 hours after lithotripsy (66% vs 71% and 72% of the aortic blood flow, respectively, p <0.05). At 1-week followup 39 unobstructed renal units (65%) showed no significant difference in renal perfusion at any time while 21 (35%) obstructed renal units showed a significant decrease in renal perfusion compared to before and 2 to 4 hours after lithotripsy (63% vs 76% and 75%, p = 0.003 and 0.005, respectively). Hematomas were observed in 7 cases (12%) 2 to 4 hours after lithotripsy, of which 5 were subcapsular and 2 were intrarenal. Three subcapsular hematomas resolved after 1 week. Localized loss of corticomedullary differentiation was observed in 2 patients (3.3%) with intrarenal hematoma 2 to 4 hours after treatment. Generalized loss of corticomedullary differentiation was observed 1 week after lithotripsy in 5 cases (8.3%). Shock wave lithotripsy alone induces minimal, reversible acute renal morphological changes and does not induce significant changes in renal perfusion. Posttreatment obstruction has a major effect on renal perfusion on the treated side and must be managed urgently.

Arab Journal of Urology, 2012

Objective: To evaluate the detectability, size, location and density of urinary stones with unenh... more Objective: To evaluate the detectability, size, location and density of urinary stones with unenhanced computed tomography (CT), using the half-radiation (low) dose (LDCT) technique, compared with the standard-dose CT (SDCT), in obese patients.

Urology, 2013

To define the preoperative kidney and stones characteristics on noncontrast-enhanced computed tom... more To define the preoperative kidney and stones characteristics on noncontrast-enhanced computed tomography that affect the success of extracorporeal shockwave lithotripsy (SWL) for treatment of renal calculi in pediatric patients. From 2005 to 2011, 57 children (age <16 years) with documented preoperative noncontrast-enhanced computed tomography scans underwent SWL for treatment of renal stones and were included in the present study. Stone size, site, multiplicity, average skin-to-stone distance, stone attenuation value, and kidney morphology were determined from the preoperative noncontrast-enhanced computed tomography scans. Success was defined as radiographically stone-free status at the 3-month follow-up examination after a single lithotripsy session without the need for additional sessions or ancillary procedures. After a single session of SWL, 24 children (42.1%) were stone free on the 3-month follow-up imaging study without the need for additional SWL sessions. Treatment failed in 33 patients (57.9), with residual fragments in 30 children, of whom 29 required repeat SWL, and 3 with stones that were considered unchanged and were finally treated with percutaneous nephrolithotomy. Logistic regression analysis revealed that stone attenuation in Hounsfield units (HU) and stone length were the only significant predictors of success. When the HU were stratified into 2 groups of ≤600 and >600 HU, the SWL success rate was 82.1% and 20%, respectively (P = .023). When length was stratified as ≤12 mm and >12 mm, the stone-free rate was 58.6% and 25.1%, respectively (P = .016). Stone attenuation ≤600 HU and stone length ≤12 mm were significant independent predictors of SWL success in children.

Difficult conditions in laparoscopic urologic surgery, 2010

... J urol. 1997;157:445-449. 10. Fazeli-Matin S, Gill IS, Hsu TH, Sung GT, Novick AC. ... Atlas ... more ... J urol. 1997;157:445-449. 10. Fazeli-Matin S, Gill IS, Hsu TH, Sung GT, Novick AC. ... Atlas of clinical urology; vol 3. 25. El-Ghoneimi A, Farhat W, Bolduc S, Bagli D, McLorie G, Khoury A. Retroperitoneal laparo-scopic vs open partial nephroureterectomy in children. BJu Int. ...

Urolithiasis, 2012

ABSTRACT Treatment of calculi in patients with congenital renal anomalies (such as horseshoe, ect... more ABSTRACT Treatment of calculi in patients with congenital renal anomalies (such as horseshoe, ectopic, autosomal dominant polycystic kidneys, and duplex systems) requires special considerations. These kidneys had abnormal vascular, altered calyceal orientation, and variable anatomical relations with the surrounding viscera. Nowadays, minimally invasive techniques (such as extracorporeal shock wave lithotripsy [SWL], fl exible ureterorenoscopy [F-URS], percutaneous nephrolithotomy [PNL] and laparoscopic pyelolithotomy) are the most frequently used modalities for treatment of calculi in both normal and anomalous kidneys. They offer high stone-free rates with minimal morbidity and improved recovery. However, there are many challenges in utilization of these modalities in patients with renal anomalies. In this chapter, we describe indications, techniques, and results of minimally invasive treatments for calculi in anomalous kidneys.

Urology, 2004

Objectives. To present our experience with percutaneous nephrolithotomy (PCNL) in the treatment o... more Objectives. To present our experience with percutaneous nephrolithotomy (PCNL) in the treatment of large stones within horseshoe kidneys. Methods. The study included 34 patients with 45 stone-bearing horseshoe kidneys treated by PCNL in one center. The indications for PCNL were large stone burden (greater than 2 cm) in 10 kidneys (22.2%), multiple complex stones in 22 (48.9%), staghorn stones in 3 (6.7%), and failed extracorporeal shock wave lithotripsy (ESWL) in 10 kidneys (22.2%). All PCNL procedures were performed in a standard one-session technique with fluoroscopic guidance. Procedures were evaluated for intraoperative and postoperative complications, use of auxiliary procedures (second-look PCNL, ureteroscopy, and ESWL), and length of hospital stay. Moreover, the stone-free rate was calculated at discharge from the hospital and 3 months later. In addition, we assessed the need for secondary intervention during a mean follow-up of 75 Ϯ 16 months (range 6 to 108). Results. The stone burden ranged from 264 to 2408 mm 2 (mean 664 Ϯ 153). Access to the horseshoe kidneys was supracostal in 10 (22.2%) and subcostal in 35 kidneys (77.8%). A single tract was used in 37 (82%), and two tracts were created in the remaining 8 kidneys (18%). Major complications were seen in six PCNL procedures (13.3%) and included significant hematuria requiring blood transfusion in three, septicemia in one, ureteral obstruction in one, and colonic injury in one. All complications were successfully treated. Auxiliary procedures were required in 12 patients (35.3%) and included ureteroscopy in 1, second-look PCNL in 3, and ESWL to fragment residual caliceal stones in 8 patients. The mean hospital stay was 4 Ϯ 1.9 days (range 3 to 12). The stone-free rate was 82% at discharge and 89% at 3 months. During the course of follow-up, 19 patients (56%) developed stone recurrence and were successfully treated with ESWL in 8 and PCNL in 11. Conclusions. PCNL is a safe and effective procedure in the treatment of large stones within horseshoe kidneys. UROLOGY 64: 426-429, 2004.

Urology, 2012

To determine factors affecting the stone-free rate and complications of percutaneous nephrolithot... more To determine factors affecting the stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of staghorn stones. The computerized database of patients who underwent PNL for treatment of staghorn stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting stone-free and complication rates. The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral stones). The stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual stones were complete staghorn stone and presence of secondary calyceal stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Factors affecting the incidence of residual stones after PNL are complete staghorn stones and the presence of secondary calyceal stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive.

Research on Allianz Arena Stadium

Official FC Bayern Munchen Website

Journal of endourology / Endourological Society, 2005

It is rare for hydatid disease to be encountered primarily in the urogenital system or retroperit... more It is rare for hydatid disease to be encountered primarily in the urogenital system or retroperitoneum. Moreover, prostatic involvement is extremely rare. We present a case report of prostatic hydatid cyst that was treated with laparoscopic excision. We reviewed diagnosis and management of hydatid disease of the urogenital tract.

Abstract Objectives: To present treatments for kidney preservation in the management of emphysema... more Abstract Objectives: To present treatments for kidney preservation in the management of emphysematous pyelonephritis (EPN), and to evaluate the functional outcome of preserved kidneys during the follow-up. Patients and methods: The computerized files of patients with EPN from 2000 to 2010 were reviewed. After initial resuscitation, ultrasonography-guided percutaneous tubes were placed for drainage of infected fluid and gas. A radio-isotopic renal scan was done after stabilization of the patients’ condition. Preservation of the affected kidney was attempted when the differential function was >10%. A renal isotopic scan was taken during the follow-up to evaluate renographic changes in preserved kidneys. Results: The study included 33 kidneys in 30 consecutive patients (mean age 51.7 years, SD 10.9). Kidney preservation was applicable for 23 kidneys (20 patients). Preservation methods included percutaneous nephrostomy for 12, percutaneous tube drain for two and conservative treatmen...

The Journal of Urology, 2015

We compared outcomes of percutaneous nephrolithotomy and retrograde intrarenal surgery in the tre... more We compared outcomes of percutaneous nephrolithotomy and retrograde intrarenal surgery in the treatment of children with renal calculi larger than 2 cm. A total of 38 patients younger than 16 years with renal calculi larger than 2 cm were randomized to undergo percutaneous nephrolithotomy or retrograde intrarenal surgery between May 2011 and February 2014. Demographic data, stone criteria, operative technique, radiation time, complications, blood transfusion, hemoglobin decrease, stone-free rate and length of hospital stay were compared between the groups. Stone-free status was documented if there were no residual stones after 1 month. The study included 43 renal units, of which 21 were subjected to retrograde intrarenal surgery and 22 to percutaneous nephrolithotomy. Operative time was comparable for both groups. Mean radiation time and hospital stay were longer after percutaneous nephrolithotomy (p <0.001). Stone-free rate was significantly lower after retrograde intrarenal surgery monotherapy vs percutaneous nephrolithotomy monotherapy (71% vs 95.5%, p = 0.046). Patients in the percutaneous nephrolithotomy group had significantly more complications compared to the retrograde intrarenal surgery group (p = 0.018). Three patients in the percutaneous nephrolithotomy group received blood transfusions, compared to none in the retrograde intrarenal surgery group (p = 0.015). For treatment of large or complex renal stones in pediatric patients percutaneous nephrolithotomy monotherapy has the advantage of better stone-free rates, while retrograde intrarenal surgery has the advantages of decreased radiation exposure, fewer complications and shorter hospital stay.

Arab Journal of Urology, 2015

Objective: To compare the efficacy, safety and cost of extracorporeal shockwave lithotripsy (ESWL... more Objective: To compare the efficacy, safety and cost of extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL) for treating a 20-30 mm single renal pelvic stone.

The Journal of Urology, 2015

The Journal of Urology, 2015

TSW Urology, 2006

The first-line management of renal stones between 20-30 mm remains controversial. The Extracorpor... more The first-line management of renal stones between 20-30 mm remains controversial. The Extracorporeal Shock Wave Lithotripsy (ESWL) stone-free rates for such patient groups vary widely. The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL in such controversial groups.

The Journal of Urology, 2014

We studied acute renal morphological and hemodynamic changes after shock wave lithotripsy of rena... more We studied acute renal morphological and hemodynamic changes after shock wave lithotripsy of renal stones. A total of 60 adult patients with a single renal stone 25 mm or less in a radiologically normal urinary tract were eligible for shock wave lithotripsy and included in analysis. Study exclusion criteria were hypertension, diabetes mellitus, previous recent stone management and other contraindications to shock wave lithotripsy. Renal perfusion and morphological changes were evaluated by dynamic magnetic resonance imaging before, and 2 to 4 hours and 1 week after lithotripsy. In all cases there was a statistically significant decrease in renal perfusion 1 week after shock wave lithotripsy compared to before and 2 to 4 hours after lithotripsy (66% vs 71% and 72% of the aortic blood flow, respectively, p <0.05). At 1-week followup 39 unobstructed renal units (65%) showed no significant difference in renal perfusion at any time while 21 (35%) obstructed renal units showed a significant decrease in renal perfusion compared to before and 2 to 4 hours after lithotripsy (63% vs 76% and 75%, p = 0.003 and 0.005, respectively). Hematomas were observed in 7 cases (12%) 2 to 4 hours after lithotripsy, of which 5 were subcapsular and 2 were intrarenal. Three subcapsular hematomas resolved after 1 week. Localized loss of corticomedullary differentiation was observed in 2 patients (3.3%) with intrarenal hematoma 2 to 4 hours after treatment. Generalized loss of corticomedullary differentiation was observed 1 week after lithotripsy in 5 cases (8.3%). Shock wave lithotripsy alone induces minimal, reversible acute renal morphological changes and does not induce significant changes in renal perfusion. Posttreatment obstruction has a major effect on renal perfusion on the treated side and must be managed urgently.

Arab Journal of Urology, 2012

Objective: To evaluate the detectability, size, location and density of urinary stones with unenh... more Objective: To evaluate the detectability, size, location and density of urinary stones with unenhanced computed tomography (CT), using the half-radiation (low) dose (LDCT) technique, compared with the standard-dose CT (SDCT), in obese patients.

Urology, 2013

To define the preoperative kidney and stones characteristics on noncontrast-enhanced computed tom... more To define the preoperative kidney and stones characteristics on noncontrast-enhanced computed tomography that affect the success of extracorporeal shockwave lithotripsy (SWL) for treatment of renal calculi in pediatric patients. From 2005 to 2011, 57 children (age <16 years) with documented preoperative noncontrast-enhanced computed tomography scans underwent SWL for treatment of renal stones and were included in the present study. Stone size, site, multiplicity, average skin-to-stone distance, stone attenuation value, and kidney morphology were determined from the preoperative noncontrast-enhanced computed tomography scans. Success was defined as radiographically stone-free status at the 3-month follow-up examination after a single lithotripsy session without the need for additional sessions or ancillary procedures. After a single session of SWL, 24 children (42.1%) were stone free on the 3-month follow-up imaging study without the need for additional SWL sessions. Treatment failed in 33 patients (57.9), with residual fragments in 30 children, of whom 29 required repeat SWL, and 3 with stones that were considered unchanged and were finally treated with percutaneous nephrolithotomy. Logistic regression analysis revealed that stone attenuation in Hounsfield units (HU) and stone length were the only significant predictors of success. When the HU were stratified into 2 groups of ≤600 and >600 HU, the SWL success rate was 82.1% and 20%, respectively (P = .023). When length was stratified as ≤12 mm and >12 mm, the stone-free rate was 58.6% and 25.1%, respectively (P = .016). Stone attenuation ≤600 HU and stone length ≤12 mm were significant independent predictors of SWL success in children.

Difficult conditions in laparoscopic urologic surgery, 2010

... J urol. 1997;157:445-449. 10. Fazeli-Matin S, Gill IS, Hsu TH, Sung GT, Novick AC. ... Atlas ... more ... J urol. 1997;157:445-449. 10. Fazeli-Matin S, Gill IS, Hsu TH, Sung GT, Novick AC. ... Atlas of clinical urology; vol 3. 25. El-Ghoneimi A, Farhat W, Bolduc S, Bagli D, McLorie G, Khoury A. Retroperitoneal laparo-scopic vs open partial nephroureterectomy in children. BJu Int. ...

Urolithiasis, 2012

ABSTRACT Treatment of calculi in patients with congenital renal anomalies (such as horseshoe, ect... more ABSTRACT Treatment of calculi in patients with congenital renal anomalies (such as horseshoe, ectopic, autosomal dominant polycystic kidneys, and duplex systems) requires special considerations. These kidneys had abnormal vascular, altered calyceal orientation, and variable anatomical relations with the surrounding viscera. Nowadays, minimally invasive techniques (such as extracorporeal shock wave lithotripsy [SWL], fl exible ureterorenoscopy [F-URS], percutaneous nephrolithotomy [PNL] and laparoscopic pyelolithotomy) are the most frequently used modalities for treatment of calculi in both normal and anomalous kidneys. They offer high stone-free rates with minimal morbidity and improved recovery. However, there are many challenges in utilization of these modalities in patients with renal anomalies. In this chapter, we describe indications, techniques, and results of minimally invasive treatments for calculi in anomalous kidneys.

Urology, 2004

Objectives. To present our experience with percutaneous nephrolithotomy (PCNL) in the treatment o... more Objectives. To present our experience with percutaneous nephrolithotomy (PCNL) in the treatment of large stones within horseshoe kidneys. Methods. The study included 34 patients with 45 stone-bearing horseshoe kidneys treated by PCNL in one center. The indications for PCNL were large stone burden (greater than 2 cm) in 10 kidneys (22.2%), multiple complex stones in 22 (48.9%), staghorn stones in 3 (6.7%), and failed extracorporeal shock wave lithotripsy (ESWL) in 10 kidneys (22.2%). All PCNL procedures were performed in a standard one-session technique with fluoroscopic guidance. Procedures were evaluated for intraoperative and postoperative complications, use of auxiliary procedures (second-look PCNL, ureteroscopy, and ESWL), and length of hospital stay. Moreover, the stone-free rate was calculated at discharge from the hospital and 3 months later. In addition, we assessed the need for secondary intervention during a mean follow-up of 75 Ϯ 16 months (range 6 to 108). Results. The stone burden ranged from 264 to 2408 mm 2 (mean 664 Ϯ 153). Access to the horseshoe kidneys was supracostal in 10 (22.2%) and subcostal in 35 kidneys (77.8%). A single tract was used in 37 (82%), and two tracts were created in the remaining 8 kidneys (18%). Major complications were seen in six PCNL procedures (13.3%) and included significant hematuria requiring blood transfusion in three, septicemia in one, ureteral obstruction in one, and colonic injury in one. All complications were successfully treated. Auxiliary procedures were required in 12 patients (35.3%) and included ureteroscopy in 1, second-look PCNL in 3, and ESWL to fragment residual caliceal stones in 8 patients. The mean hospital stay was 4 Ϯ 1.9 days (range 3 to 12). The stone-free rate was 82% at discharge and 89% at 3 months. During the course of follow-up, 19 patients (56%) developed stone recurrence and were successfully treated with ESWL in 8 and PCNL in 11. Conclusions. PCNL is a safe and effective procedure in the treatment of large stones within horseshoe kidneys. UROLOGY 64: 426-429, 2004.

Urology, 2012

To determine factors affecting the stone-free rate and complications of percutaneous nephrolithot... more To determine factors affecting the stone-free rate and complications of percutaneous nephrolithotomy (PNL) for treatment of staghorn stones. The computerized database of patients who underwent PNL for treatment of staghorn stones between January 2003 and January 2011 was reviewed. All perioperative complications were recorded and classified according to modified Clavien classification system. The stone-free rate was evaluated with low-dose noncontrast computed tomography (CT). Univariate and multivariate statistical analyses were performed to determine factors affecting stone-free and complication rates. The study included 241 patients (125 male and 116 female) with a mean age of 48.7 ±14.3 years. All patients underwent 251 PNL (10 patients had bilateral stones). The stone-free rate of PNL monotherapy was 56% (142 procedures). At 3 months, the stone-free rate increased to 73% (183 kidneys) after shock wave lithotripsy. Independent risk factors for residual stones were complete staghorn stone and presence of secondary calyceal stones (relative risks were 2.2 and 3.1, respectively). The complication rate was 27% (68 PNL). Independent risk factors for development of complications were performance of the procedure by urologists other than experienced endourologist and positive preoperative urine culture (relative risks were 2.2 and 2.1, respectively). Factors affecting the incidence of residual stones after PNL are complete staghorn stones and the presence of secondary calyceal stones. Complications are significantly high if PNL is not performed by an experienced endourologist or if preoperative urine culture is positive.

Urology, 2011

To evaluate the ability of noncontrast computed tomography (NCCT) to predict stone composition an... more To evaluate the ability of noncontrast computed tomography (NCCT) to predict stone composition and fragility for treatment with extracorporeal shock wave lithotripsy (SWL).

Urology, 2014

To evaluate the long-term functional outcome of percutaneous nephrolithotomy (PNL) for calculi in... more To evaluate the long-term functional outcome of percutaneous nephrolithotomy (PNL) for calculi in solitary kidneys and to determine factors leading to renal function deterioration. The computerized files of patients with solitary kidneys who underwent PNL between January 2002 and December 2009 were retrospectively reviewed. Patients with follow-up <2 years were excluded. Complications, secondary procedures, and stone-free rates were recorded. Changes in the renal function were judged by comparing preoperative and postoperative estimated glomerular filtration rates. Preoperative, intraoperative, and postoperative factors that may affect renal function were tested using univariate and multivariate analyses to define risk factors for deterioration of renal function on long-term follow-up. The study included 200 patients (133 men [66.5%] and 67 women [33.5%] with mean age 52.3 ± 11.7 years). Complications were reported in 34 patients (17%). Severe bleeding was noticed in 10 patients (5%). The overall stone-free rate was 89.5%. After a mean follow-up of 3 ± 1.4 years (range, 2-8), there was significant improvement of the estimated glomerular filtration rate from 57 to 64 mL/min (P <.001). Thirty-one patients (15.5%) showed deterioration of the renal function. Multiple punctures and postoperative bleeding were independent risk factors for renal function deterioration (odds ratio was 3.7 and 4.5, respectively). PNL for calculi in solitary kidneys provided significant improvement in renal function at long-term follow-up. Multiple punctures and severe bleeding are independent risk factors for deterioration of the kidney function.