1493Vol. 11    |    No. 02    |     March- April 2014    |U R O LO G Y   J O U R N A L

Figure 1. Kidney-ureter-bladder X-ray demonstrates multiple radio-opaque shadows in left renal 
area.

Figure 2. Extracted 323 renal stones measur-
ing from 5 mm to 2 cm.

Figure 3. Postoperative kidney-ureter-bladder 
X-ray shows no residual calculus.

323 Renal Stones in a Functional Kidney
Bhavesh Devkaran, Navneet Sharma, Alok Pandey, Arun Kumar Gupta

Corresponding Author:  

Bhavesh Devkaran, MD
Department of Surgery, Indira Gandhi 
Medical College, Shimla Himachal 
Pradesh, India.

Tel: +91 177 2628919
Fax: +91 177 2883401
E-mail: devkaranbhavesh@gmail.
com

Received March 2013
Accepted April 2013

Department of Surgery, Indira 

Gandhi Medical College, Shimla 

Himachal Pradesh, India.

A 50‎years‎old‎male‎patient‎presented‎with‎occasional‎left‎flank‎pain‎and‎irritative‎lower‎urinary‎tract‎symptoms‎with‎1‎to‎2‎episodes‎of‎hematuria‎since‎1‎to‎2‎years‎ago.‎No‎history‎of‎other‎medical‎or‎surgical‎diseases‎was‎noted.‎His‎general‎physical‎examination‎and‎routine‎investigations‎were‎normal.‎Kidney-ureter-bladder‎(KUB)‎
X-ray‎revealed‎multiple‎radio-opaque‎shadows‎in‎left‎renal‎area‎(Figure‎1).‎On‎ultrasonography,‎multiple‎calculi‎in‎left‎kid-

ney‎with‎prominent‎pelvicalyceal‎system‎causing‎ureteropelvic‎junction‎(UPJ)‎narrowing‎was‎seen.‎Intravenous‎urography‎

(IVU)‎demonstrated‎bilateral‎functioning‎kidneys,‎multiple‎calculi‎with‎prominent‎pelvis‎and‎grade‎IV‎hydronephrosis‎in‎

left‎side,‎and‎UPJ‎narrowing.‎Renal‎scintigraphy‎revealed‎relative‎function‎of‎40%.‎Diagnosis‎of‎left‎renal‎calculi‎with‎UPJ‎

narrowing‎was‎made.‎Patient‎was‎planned‎for‎surgery‎and‎left‎pyelonephrolithotomy‎with‎Anderson-Hynes‎pyeloplasty‎were‎

done.‎Intraoperatively,‎left‎hydronehprotic‎kidney‎with‎impacted‎multiple‎stones‎were‎seen.‎Renal‎parenchyma‎was‎thinned‎

out‎at‎places.‎UPJ‎narrowing‎was‎also‎present.‎Maximum‎stones‎were‎extracted‎through‎pyelolithotomy‎and‎rest‎through‎

nephrolithotomy‎which‎were‎323‎in‎number,‎measuring‎from‎5‎mm‎to‎2‎cm‎(Figure‎2).‎Intraoperatively‎stone‎free‎status‎was‎

confirmed‎with‎C-arm.‎Postoperatively‎his‎KUB‎X-ray‎shows‎no‎residual‎calculus‎(Figure‎3).‎

PICTORIAL