Udaipur, Sep 15: A 33-year-old man with staghorn multiple large stones in the right kidney, chronic kidney disease and severely reduced kidney function was successfully treated at Paras Health Udaipur through a single-stage, single-tract PCNL. More than 500 stone fragments were removed through a single tract, with the complex case managed by Dr. Vishwas Baheti, Director of Urology, Paras Health Udaipur.
The patient had a history of bilateral renal calculi, meaning kidney stones in both kidneys, and had previously undergone PCNL at another hospital. He was admitted under the Urology team as a high-risk surgical candidate, with severe renal dysfunction, severe anaemia and a requirement for intermittent haemodialysis as and when required, putting him at risk of requiring dialysis after surgery. Evaluation showed stones involving all the calyces of the right kidney, the chambers that collect urine.
Given his condition, the team first established urinary drainage through a right-sided PCN, which involves placing a tube directly into the kidney through the skin to drain urine when normal flow is obstructed. This was followed by bilateral ureteric stenting, placing thin tubes in both ureters to maintain urinary flow.
The team then performed PCNL, a minimally invasive procedure in which the kidney is accessed through a small tract created through the skin to reach and fragment the stones. The approach enabled the surgical team to clear the extensive stone burden through a single access route in one stage.
Dr. Vishwas Baheti, Director of Urology, Paras Health Udaipur, said,
“This was a challenging intervention because of the patient's CKD, severely compromised renal function and haemoglobin level of around 6 g/dL. He had also undergone PCNL previously and was receiving intermittent haemodialysis, which increased the risks associated with surgery. We opted for a single-stage approach through one tract to achieve extensive clearance while limiting renal access. Despite the clinical risks, the patient did not require haemodialysis after the procedure.”
Following the procedure, the patient recovered well and was discharged on the third day without complications. He is currently healthy, working well and does not require haemodialysis.
The patient said,
“My condition had been a major concern for me and my family, especially because I was already dealing with serious kidney problems and had undergone treatment earlier. I am grateful to Dr. Vishwas Baheti and the team at Paras Health Udaipur for explaining the treatment and supporting me throughout the process. The care I received gave me confidence, and I am relieved to have recovered well and returned to my normal routine.”
The case highlights the value of a single-stage, single-tract PCNL for extensive stone clearance in a high-risk patient with significant renal dysfunction, while limiting access to the kidney.
