Predictors of renal angioembolization outcome:A retrospective analysis with 148 patients at a tertiary urology institute

Objective:The aim of this study was to evaluate the predictor of unsuccessful outcome of renal angioembolization(RAE).Knowing those predictors may help in avoiding unnecessary RAE procedures and their associated side effects,while helping to prepare for an alternate procedure and improving patient's overall satisfaction.Methods:A retrospective analysis between January 2006 and December 2018 was performed,and the indications for RAE were classified into post-traumatic,iatrogenic,renal tumors,and spontaneous.Patients who underwent RAE prior to nephrectomy were eliminated.Computed tomography angiography was performed in patients with normal renal function and those who had no contrast allergy,otherwise magnetic resonance angiography was performed.For the purpose of statistical analysis,we stratified patients into two main categories based on the final outcome—successful or failed.Results:Of 180 patients,32 with negative angiography were eliminated,leaving 148 patients;136(91%)had successful outcomes after one or more trials and 12 had unsuccessful outcomes.The mean age was 45±15 years,and 105(71%)were male.Neither gender,side of the lesion,presence of hematuria,indication for RAE,nor the type of lesion affected the outcome.On the other hand,renal anatomy with presence of accessory artery was the only predictor to failed RAE(p=0.001).Failed RAE trial was a predictor for nephrectomy as a secondary procedure(p=0.03).Conclusion:No pre-procedural predictors could anticipate the RAE outcome,and different indications can be scheduled to RAE,which is equally effective.The presence of accessory renal artery on diagnostic angiography is the only factor that may predict the failure of the procedure.

One-stage versus staged ureteroscopy and percutaneous nephrolithotomy for simultaneous ureteral and renal stones

Objectives:This study is aimed to investigate the outcome of one-stage ureteroscopy(URS)and percutaneous nephrolithot(PCNL)for simultaneous ureteral and renal stones over 10years at a tertiary urology institute.Materials and methods:We retrospectively analyzed the data of patients who were operated on for simultaneous ureteral and renal stones from January 2011 to December 2020.Patients were divided into 2 groups:group A,who underwent one-stage URS and prone PCNL,and group B,who underwent staged procedures.The overall success,complications,operative time,and hospital stays were compared between the 2 groups.Results:Data for 190 patients were reviewed;mean age was 50±13 years old,and 146(77%)were male.The one-stage(A)and staged(B)groups included 102 and 88 patients,respectively.Group A included older patients,with a high The American Society of Anesthesiologists score,while group B included more patients with multiple or staghorn stones.The one-stage group recorded shorter operative time(120±12min vs.140±16min,p=0.02)and shorter hospital stays(3 days[2-6]vs.4 days[3-9],p=0.06).Otherwise,both groups had equal outcomes in terms of success rates and complications.Conclusions:PCNL and URS can be performed in one-session for simultaneous ureteral and renal stones,except for multiple renal and staghorn stones.The results are comparable to those of the staged procedure in terms of success rate and complications,with the advantage of a shorter operative time and hospital stay.