Renal Stones Case Study

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FATE OF RESIDUAL STONES AFTER PERCUTANEOUS NEPHROLITHOTOMY IN ZAGAZIG UNIVERSITY HOSPITAL INTRODUCTION Management of renal stones is greatly variable and ranges from the medical treatment to the most invasive open surgery {1} The main goal of any intervention for urolithiasis is complete stone removal in order to achieve a stone free status{2} Percutaneous nephrolithotomy (PNL) has become the treatment of choice for large or complex stones. The Current guidelines of the European Association of Urology recommend PNL as the treatment of choice for stones more than 2cm and lower polar stones more than 1 cm in patients with unfavorable factors for ESWL. It is also a second line treatment in pelvic, upper or middle caliceal stones from 1-2cm…show more content…
Moreover, since the psoas major muscle has a shape of a cone, the kidneys also are dorsal and inclined on the longitudinal axis. There fore,the superior poles are more medial and more posterior than the inferior poles (see Figure -1).Because the hilar region is rotated anteriorly on the psoas muscle, the lateral borders of both kidneys are posteriorly positioned. It means that the kidneys are angled 30 to 50° behind the frontal(coronal) plane (Figure…show more content…
The renal pyramids comprise the loops of Henle and collecting ducts; these ducts join to form the papillary ducts (about 20) which open at the papillary surface (are a cribrosa papillae renalis, draining urine into the collecting system(into the fornix of a minor calix).A minor calix is defined as the calix that is in immediate apposition to a papilla (see Figures-4 ). The renal minor calices drain the renal papillae and range in number from 5 to14 (mean, 8); although the number of minor calices is widely varied, 70% of the kidneys presenting 7 to 9 minor

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