Bilateral Staghorn with CKD

• 15 Jan 2020 10:22:49 AM
• |Endo Urology

Comments(8)

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  Dr. Anil Takvani

  15 Jan 2020 11:25:39 AM

  Dear Nitesh, Are these pictures post operative?

  

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  Dr. Anil Takvani

  15 Jan 2020 11:41:09 AM

  What was S.creatinine when you operated the patient? Was he converted on bilateral PCN prior to surgery?

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  Nitesh Jain

  15 Jan 2020 04:45:12 PM

  Sorry one image is not related to this shared wrongly .... is there a way to edit this

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  Nitesh Jain

  15 Jan 2020 04:48:09 PM

  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

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  Nitesh Jain

  15 Jan 2020 04:56:59 PM

  This image is of not this patient

  

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  Dr. Anil Takvani

  15 Jan 2020 05:40:58 PM

  Nitesh, 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

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  Prabir Basu

  18 Jan 2020 11:02:43 PM

  Is Desmopressin used here to reduce risk of bleeding ? @ what dose?

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  Haresh G Thummar

  23 Feb 2020 01:18:30 PM

  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 don’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.