Curative Effect of Flexible Ureteroscope with 200 μm Holmium Laser Lithotripsy in the Treatment of Medullary Sponge Kidney Calculi_West China Medical Journal

Authors：

 LuoHua , LiaoGaoyuan , LiuChen , WangXiaobo

Department of Urology, the Second People's Hospital of Deyang, Deyang, Sichuan 618000, P. R. China;

Corresponding author：

Keywords：

Medullary sponge kidney; Calculi; Flexible ureteroscope; Holmium laser

DOI：

10.7507/1002-0179.201600497

Video：

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Objective To investigate the clinical efficacy and safety of lithotripsy under flexible ureteroscope using 200 μm holmium laser for medullary sponge kidney stones. Methods We identified and retrospectively reviewed 10 patients who underwent flexible ureteroscopic lithotripsy for medullary sponge kidney calculi between January 2013 and July 2014. The remission of clinical symptoms and incidence of perioperative complications were observed. Results The staged surgery was performed on 10 bilateral cases with one session for each kidney. The operative time of our cohort was 130-180 minutes. The postoperative average hemoglobin was not significantly reduced (110.6 g/L) as compared with preoperative average hemoglobin (116.8 g/L) (P>0.05). Two patients had fever after operation and temperatures became normal by anti-infection. The renal function and plain film of kidney-ureter-bladokr (KUB) and CT scan were rechecked for all cases on three months after operation. The kidney function in 3 cases of chronic renal failure was ameliorated to varying degrees. The postoperative average of serum creatinine (196.2 μmol/L) was reduced as compared with the preoperative average serum creatinine (385.7 μmol/L) (P<0.05). Six patients reported spontaneous discharge of residuary stones during three months after surgery. KUB and CT scan proved significant reduction of the loads of stones for all cases after operation. Conclusion Flexible ureteroscope with 200 μm holmium laser lithotripsy is a safe and effective treatment for medullary sponge kidney stones based on its effect on amelioration of symptom and renal function.

Citation： LuoHua, LiaoGaoyuan, LiuChen, WangXiaobo. Curative Effect of Flexible Ureteroscope with 200 μm Holmium Laser Lithotripsy in the Treatment of Medullary Sponge Kidney Calculi. West China Medical Journal, 2016, 31(11): 1811-1813. doi: 10.7507/1002-0179.201600497 Copy

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1. 林鹭, 郁胜强. 髓质海绵肾的新认识[J].中国全科医学, 2015(18):2213-2216.
2. Gambaro G, Feltrin G, Lupo A, et al. Medullary sponge kidney (Lenarduzzi-Cacchi-Ricci disease):a Padua medical school discovery in the 1930s[J].Kidney Int, 2006, 69(4):663-670.
3. Kuiper JJ. Medullary sponge kidney[J].Perspect Nephrol Hypertens, 1976, 4(1):151-171.
4. Rommel D, Pirson Y. Medullary sponge kidney part of a congenital syndrome[J].Nephrol Dial Transplant, 2001, 16(3):634-636.
5. Ginalski JM, Portmann L, Jaeger P. Does medullary sponge kidney cause nephrolithiiasis[J].AJR Am J Roentgenol, 1990, 155(2):299-302.
6. Parks JH, Coe FL, Strauss AL. Calcium nephrolithiasis and medullary sponge kidney in women[J].N Engl J Med, 1982, 306(18):1088-1091.
7. 雷鸣, 刘春晓, 曾国华, 等. 髓质海绵肾合并代谢异常的诊断和意义[J].南方医科大学学报, 2010, 30(2):403-404, 406.
8. Fabris A, Lupo A, Bernich P, et al. Long-Term treatment with potassium citrate and renal stones in medullary sponge kidney[J].Clin J Am Soc Nephrol, 2010, 5(9):1663-1668.
9. Forster JA, Taylor J, Browning AJ, et al. A review of the natural progression of medullary sponge kidney and a novel grading system based on intravenous urography findings[J].Urol Int, 2007, 78(3):264-269.
10. 张和平, 王长福, 靳海英, 等. 髓质海绵肾的影像学检查[J].实用医学影像杂志, 2010, 11(6):374-376.
11. 周春香, 郭燕, 刘明娟, 等. 髓质海绵肾的CT诊断[J].临床放射学杂志, 1998, 17(4):226-228.
12. 杨震宇, 夏圻儿, 张旭, 等. 髓质海绵肾合并肾结石的诊断和治疗[J].中国医师进修杂志, 2012, 35(11):54-56.
13. 秦军, 王禾, 袁建林, 等. 髓质海绵肾的诊断和治疗(附8例报告)[J].现代泌尿外科杂志, 2007, 12(6):361-362.
14. 孙颖浩. 泌尿系结石微创治疗的若干问题[J].中国微创外科杂志, 2011, 11(1):6-8, 12.
15. 曹全富, 王洛夫, 兰卫华, 等. 输尿管软镜在髓质海绵肾结石治疗中的应用[J].局解手术学杂志, 2014(6):644-646.

West China Medical Journal

Curative Effect of Flexible Ureteroscope with 200 μm Holmium Laser Lithotripsy in the Treatment of Medullary Sponge Kidney Calculi

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