Percutaneous nephrolithotripsy in patients with urinary diversion

• Grant number: 24/16885-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2024
• End date: October 31, 2025
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Fábio César Miranda Torricelli
• Grantee: Vinicius Oberdan Souza Reis
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Urinary diversions are extremely important to ensure the proper functioning of the upper urinary tract and preserve the renal function of patients.¹ Although urinary reconstructions are capable of preserving renal function and often improving the quality of life of patients who need them, , some inherent complications are associated, such as urinary infections and the formation of urinary stones. Nephrolithiasis can result from metabolic changes, bacterial colonization, urinary stasis and exposure to surgical material with sutures.2 The incidence of urolithiasis in patients with urinary diversion is reported to range from 9% to 26%.3-5 Percutaneous nephrolithotripsy, the focus of our study, is challenging, since access to the ureter and contrasting the excretory route to guide renal puncture is not always possible. The use of ultrasound to guide puncture and the development of new endoscopes, lithotripters and disposable materials has helped to provide a better approach, but still has limitations.Current literature is scarce regarding the actual rates of stone-free patients with the percutaneous approach and the rates of complications in these patients in relation to the healthy population.