Are these pictures post operative?
What was S.creatinine when you operated the patient?
Was he converted on bilateral PCN prior to surgery?
Sorry one image is not related to this shared wrongly .... is there a way to edit this
No PCN done ...
Patient was dialysed before the surgery and it was done as a staged procedure ... one day apart
Preop Desmopressin was given
Pod 3 patient creating came to 4.3 ... is having good out put
This image is of not this patient
We understand you have operated this patient.
Bilateral PCNL? done, one day apart.
In my it involves many risks.
Can you please detail what exact procedure you have done and how you explained risks? Thanks
Is Desmopressin used here to reduce risk of bleeding ? @ what dose?
Bilateral staghorn stones with renal insufficiency is the scenario what I understand.we need to check his CMD, HDN status ,comorbidities,proteinuria,recurrent stone or once only(we presented interesting paper in AUA 2015 on this ) which will decide further prognosis as far as GFR is concerned. I would counsel Pt according to all these factors. I would place bilateral PCN ( May be multiple if required) . I donâ€™t know why IV contrast study was done here.?.Once he achieves Nadia S Creatinine, stages PCNL is a way to go with understanding that he might need RRT.