Urinary tract stone surgery in patients with urinary diversion and vesicostomy: a single center experience

Abstract

Objective: To report our experience in percutaneous nephrolithotomy and endoscopic urinary tract stone surgery in patientswith urinary diversion or vesicostomy.Material and Method: Data of 21 patients with urinary diversion or vesicostomy who underwent surgery for urinary tractstones in our clinic between January 2008 and January 2020 were retrospectively analyzed. Eight patients (38%) underwentpercutaneous nephrolithotomy, 2 patients (9.5%) underwent antegrade flexible ureteroscopy, 4 patients (19.0%) underwentretrograde semi-rigid or flexible ureteroscopy, 5 patients (23.8%) underwent retrograde pouch lithotripsy and 2 patients (9.5%)underwent percutaneous cystolithotripsy with vesicostomy tract entrance. Preoperative and postoperative data of the patientswere evaluated.Results: The male to female ratio was 16/5.The mean age of the patients was 54.6±10.1 years and mean preoperative stonediameter was 2.8±4.5 cm. It was determined that 14 patients (66.6%) had ileal conduit (Bricker anastomosis), 5 patients (23.8%)had ureterocutaneostomy, and 2 patients (9.5%) had vesicostomy. Stone-free rate was 85.7% after single session of treatment.In the postoperative period, febrile urinary tract infection was observed in 4 (19.0%) patients, urinary system obstructionsecondary to stone in 3 (14.2%) patients and anastomotic leakage in 1 (4.7%) patient.Conclusion: Percutaneous nephrolithotomy, antegrade ureterorenoscopy, retrograde ureterorenoscopy and vesicostomyentry cystolithotripsy are highly effective and safe methods in patients with urinary diversion and vesicostomy. The mostimportant factors affecting the success are the experience of surgical team that can apply procedural options together withcareful preoperative preparation and correct instrumentation.