Abstract：Objective: To evaluate the indication, safety and efficacy of percutaneous nephrolithotomy (PCNL) in treating medullary sponge kidney (MSK) . Methods: By using the hospital information system (HIS) databases of Renmin Hospital of Wuhan University and Xinjiang People's Hospital, we identified and retrospectively reviewed 19 patients (36 kidneys) who underwent PCNL for MSK between September 2005 and November 2013. Patients treated with other methods were excluded.Results: Chronic renal failure (CRF) was recorded in 8 cases from 19 patients. The stone burden was (214±52) mm as describled by the maxium length of the stones. The staged surgery was preformed on 17 bilateral cases with one session for each kindey, including 9 kindeys with single access tract, 22 kidneys with two access tracts and 10 with three tracts. The 2 unilateral cases were treated with two access tracts. The percutaneous renal access was established through different calices, including 20 tracts through upper calices, 36 tracts through middle calices and 10 through lower calices. The operative time of our cohort was (684±151) min with all free stones of all patients being shattered and cleared The postoperative hemoglobin was reduced by (123±57) g/L as compared with their preoperative counterpart. No transfusion was needed in this series. The rate of urinary infection related to the operation was 105% (2/19). No kidney lost. No pneumothorax or surrounding organ injury was found. All 19 cases were followed up for 112 months (range from 6 to 20 months). Seven cases reported the history of spontaneous discharge of the residuary stones. The kidey function in 8 cases of CRF was ameliorated to varing degrees, 1 and 12 months postoperation. The symptoms such as lumbodynia, gross hematuria and urinary tract infection were significantly ameliorated, and only 211% (4/19) cases complained these symptoms, but the frequency was reduced dramatically after PCNL.Conclusions: PCNL was a safe and effective treatment for MSK based on its effect on amelioration of symptom, and maintainence of the renal function.
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