Role of surgery for upper urinary tract stones in low-income countries: semi-rigid ureteroscopy and percutaneous nephrolithotomy in Benin

Abstract

Background: Percutaneous nephrolithotomy (PCNL) and semi-rigid ureteroscopy (SR-URS) are adequate therapeutic means of treating upper urinary tract stones. This study aimed to evaluate the effectiveness of this approach in managing urinary lithiasis at the National University Hospital Centre of Cotonou (CNHU-Cotonou).

Patients and methods: This was a retrospective, descriptive study conducted at the Urology Department of the CNHU-Cotonou from 28 November 2018 to 31 December 2022. The records of patients with upper urinary tract lithiasis treated with PCNL and SR-URS were reviewed and included.

Result: A total of 121 patients were included. The average age was 46 years. The average stone size was 32 mm at the renal level and 6 mm at the ureteral level. PCNL was performed in 69 cases and SR-URS in 57 cases, with complete lithotripsy rates of 73.9% and 91.2%, respectively. In 53.6% (n = 37) of cases during PCNL, postoperative drainage was made by nephrostomy. During the SR-URS, a JJ-stent was placed in 92.9% (n = 53). The postoperative course was simple in 78.5%. A postoperative urinary tract infection was observed in 61.5% of cases. The average hospital stay was two days.

Conclusion: Endoscopic surgery is now used to treat upper urinary tract stones at CNHU-Cotonou. The combination of PCNL and SRURS gives satisfactory results in our environment with limited equipment.