Payuk R. Percutaneous nephrolitotripsy in patients with urolithiasis and kidney malformations.

The thesis is devoted to choice of the optimal treatment strategy in patients with urolithiasis and kidney malformations. This paper analyzes a comprehensive examination and treatment of 48 patients with urolithiasis and anatomically normal kidneys (control group) and 85 patients with urolithiasis and abnormal kidneys (study group). Percutaneous nephrolithotripsias (PCNL) were performed in all patients. In cases of incomplete deliverance from kidney stone we used combined treatment with addition to PCNL of extracorporeal shock wave lithotripsy (ESWL). Based on a comparative analysis of the treatment results we considered PCNL as highly effective method in the treatment of large and abnormal renal staghorn stones in patients with horseshoe, dystoped and doubled kidneys. PCNL as monotherapy has achieved the stone-free rate in 81.17% cases. Using a combination of PCNL+ ESWL increases the stone-free rate to 95.3%.Based on the research performance of radionuclide renography in patients with abnormal kidney stones before and after endoscopic lithotripsy it has been proved a safety of PCNL and has been noted a tendency for the improvement of previously impared renal function in the postoperative period.We defined indications and contraindications for PCNL use in the treatment of urolithiasis in patients with kidney malformations and outlined the principles and terms of their dynamic clinical examination.