Nephrolithiasis associated with autosomal dominant polycystic kidney disease: Contemporary urological management

Purpose: We evaluate the role of contemporary urological intervention in pa tients with nephrolithiasis associated with autosomal dominant polycystic k idney disease. Materials and Methods: Intervention for upper tract stones associated with autosomal dominant polycystic kidney disease was performed in 5 women and 2 men 29 to 65 years old (mean age 47). Indications for intervention consist ed of flank pain in 6 patients and/or hematuria in 2. A total of 12 procedu res (mean 1.7 per patient) were performed, including shock wave lithotripsy in 6 patients, percutaneous nephrolithotomy in 2, retrograde endoscopy or manipulation in 3 and extended pyelonephrolithotomy in 1. Results: All patients were rendered stone-free or had only residual "dust." Hospital stay for 5 patients was 1 night or less and there were no complic ations. Renal function for each patient was stable or improved as measured by serum creatinine. Conclusions: Most patients with autosomal dominant polycystic kidney diseas e who require intervention for nephrolithiasis can be safely and effectivel y treated with essentially any or all contemporary, minimally invasive tech niques. The choice of intervention can be based primarily on size and locat ion of the upper tract stones rather than the associated presence of polycy stic kidneys.