Partial nephrectomy for urolithiasis treatment. History repeats itself?

Introduction. Presence of calculus in an enlarged isolated renal calyx requires endoscopic or percutaneous correction to remove the calculus and eliminate the cause of local urodynamic disorders. If the calyx is significantly enlarged or the parenchyma over the enlarged calyx is atrophied, the possibilities of endoscopic or percutaneous surgery may not be enough. In such a situation, laparoscopic resection of the kidney segment can be an effective method of correction. Materials and methods. During the period from 2016 to 2021, we operated on 4 patients with calculi in isolated renal calices. In 3 out of 4 patients, recurrent stone formation occurred after the previously performed PCNL. All patients had a significant expansion ofthe calyx containing the stone and local atrophy of the parenchyma. In all cases, resection of the kidney segment containing the stone was performed. In 2 cases of the upper segment and in other 2 patients the lower segment of kidney was resected. The observation period ranged from 4 to 52 months. The result was assessed by performing computer tomography (CT) of the kidneys with contrast 10-18 months after surgery. Results. Good clinical effect was achieved in all cases. During the observation period, no recurrence of stone formation in the operated kidneys was observed. CT showed normal renal function and no signs of intrarenal urodynamic impairment. Conclusion. In situations where there is a combination of a number of anatomical and clinical factors, kidney resection in urolithiasis may be justified and save the patient from relapses of the disease.