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Ultra-mini percutaneous nephrolithotomy (UMP): one more armamentarium
Article first published online: 11 JUL 2013
© 2013 The Authors. BJU International © 2013 BJU International
Volume 112, Issue 7, pages 1046–1049, November 2013
How to Cite
Desai, J. and Solanki, R. (2013), Ultra-mini percutaneous nephrolithotomy (UMP): one more armamentarium. BJU International, 112: 1046–1049. doi: 10.1111/bju.12193
- Issue published online: 11 OCT 2013
- Article first published online: 11 JUL 2013
- percutaneous lithotripsy;
- kidney calculi;
- percutaneous nephrostomy;
- To describe our newly developed technique for the removal of renal stones, which we have called ultra-mini percutaneous nephrolithotomy (UMP).
- UMP was performed in 62 patients using a 3.5-F ultra-thin telescope and specially designed inner and outer sheaths. A standard puncture was made and the tract was dilated up to 13 F.
- The outer sheath was introduced into the pelvicalyceal system and the stone was disintegrated with a 365-μ holmium laser fibre, introduced through the inner sheath.
- Stone fragments were evacuated using the specially designed sheath by creating an eddy current of saline; the fragments then came out automatically.
- The mean calculus size was 16.8 mm. Four of the 62 patients were children, three had a solitary kidney and two were obese.
- UMP was feasible in all cases with a mean (sd) 1.4 (1.0) gm/dL haemoglobin decrease and a mean hospital stay of 1.2 (0.8) days. The stone-free rate at 1 month was 86.66%.
- In two patients intraoperative bleeding obscured vision, requiring conversion to mini-percutaneous nephrolithotomy. There was one postoperative complication of hydrothorax, but there were no other postoperative complications and no auxiliary procedures were required.
- UMP is a very safe and effective method of removing renal calculi up to 20 mm. The use of consumables and disposables is minimal and the patient recovery was fast.
- Further clinical studies and direct comparison with other available techniques are required to define the place of UMP in the treatment of low-bulk and medium-bulk renal urolithiasis. It may be particularly useful for lower calyx calculi and paediatric cases.