Management of calyceal diverticular stones by pcnl and keeping a stent across the diverticulum

AIM To study the effectiveness of management of calyceal diverticular stones by Percutaneous nephrolithotomy along with placement of nephrostomy tube across the diverticular neck.
MATERIALS AND METHODS
This was a cross sectional analysis done in all calyceal diverticular stone patients who were admitted in the Urology department from Sep 2015 – Feb 2019 . The total number of patients were 13 and Male were 12 and 1 female. Patients underwent pre-operative Contrast enhanced computerised tomogram or Intravenous urogram. If creatinine is elevated non contrast imaging done followed by Retrograde pyelogram during intra operative period. Among the 13 patients seven had preoperative ESWL and underwent PCNL as ancillary procedure. corresponding calyx puncture was made and stone cleared.Stenting was done followed by placement of nephrostomy tube across diverticular neck. Stone clearance checked using using post operative ultrasound and X- ray KUB. Nephrostomy tube removal after 48 hrs. Stent was removed after 3 weeks All patients were followed up for a period of 6months to 3 years for stone recurrence and diverticular complications.
RESULTS Among 13 patients 11 patients are completely free of calculus .Two patient had a residual calculus and eswl was done and was put on long term medical treatment with alkalysers.
CONCLUSION Calycealdiverticular stones required a high index of suspicion on imaging. Simple stenting along with nephrostomy tube across the neck of diverticulum has prevented any recurrence of symptoms or stone on followup.