Repeated Percutaneous Nephrolithotomy in Patient with Recurrent Cystine Lithiasis: Preservation of Renal Function

Abstract

Cystinuria places the patient at continual risk for urinary tract stone formation. Despite aggressive medical therapy, multiple stone recurrences are common, and surgical intervention is often required. Historically, repeated open procedures have been associated with high morbidity. Extracorporeal shock wave lithotripsy has a disappointing record against cystine stones, and percutaneous nephrolithotomy has evolved into the optimal form of surgical therapy for these patients. We report on a patient whose recurrent unilateral cystine calculi necessitated four percutaneous nephrolithotomies with excellent preservation of renal anatomy and function. This result compares favorably with those obtained from repeated open stone procedures in the cystinuric population.