PERCUTANEOUS CYSTOLITHOTOMY WITH ENDOTRACHEAL-TUBE TRACT DILATION AFTER URINARY-TRACT RECONSTRUCTION

Purpose: The effectiveness of a percutaneous approach to intact remova l of large calculi from the urinary reservoir after urinary tract reco nstruction was reviewed. Materials and Methods: The original site of t he reservoir drainage tube was used for percutaneous access. After dil ation of the tract to 34F a number 10 endotracheal tube was advanced t hrough the tract, and the balloon (diameter up to 43 mm.) was inflated . The rigid nephroscope was then passed through the tract and calculi were removed intact without the need for ultrasonic or electrohydrauli c lithotripsy. Results: Removal of single or multiple reservoir calcul i attempted in 4 patients was successful in 3. Patients were discharge d home within 2 days. Conclusions: The technique of over dilation of t he percutaneous tract allows removal of multiple large calculi in sele ct patients without the need for lithotripsy.