Percutaneous Nephrolithotomy: A Mini Invasive Approach for Renal and Pelvic Stones. Initial Experience from a Resource-Limited Setting in Douala Cameroon

Abstract

Background and Aim: We present in this paper the technique and results of percutaneous nephrolithotomy as a minimally invasive treatment for large renal and pyeloureteric junction stones at the Centre medico-chirugical d’urologie in Douala, Cameroon. Methods: This was a retrospective study carried out from January 2019 to July 2022. We included 25 patients with calculi in the renal pelvis and pyeloureteric junction treated through percutaneous nephrolithotomy. Results: We included a total of 25 patients (18 men and 7 women) with a median age of 44 [36-48] years. Of the 25 patients, 23(88%) had a single calculus and 3(22%) presented with a Staghorn calculus. The median size of the calculi was 23.5 [20.25–27.75] mm and in 60% of cases; the stone was on the right side of the body. In all cases, the definitive diagnosis was made using abdominal CT scans and in 20 (80%) patients, the diagnosis was made incidentally during a CT scan for other reasons. All patients were treated through percutaneous nephrolithotomy, performed in the prone position in 21(84%) patients. Three patients who had a positive urine culture prior to the procedure benefited from a preoperative double J stent placement and all patients had post-surgery percutaneous drain placement which was left in place for 24 hours. The median surgery duration was 135 [120–165] minutes. Seventeen patients (68%) were stone free after the procedure. Conclusion: Percutaneous nephrolithotomy is an effective mini-invasive technique in the treatment of voluminous kidney and pyeloureteric junction stones. It is reliable, reproducible and has fewer complications and, therefore, proves to be an excellent choice in Sub-Saharan Africa.