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Introduction and Objectives: To compare the outcomes of these minimally invasive procedures in this patient population. Patients and Methods: The database of our institution has been retrospectively reviewed, and medical records of urolithiasis patients with a solitary kidney who underwent flexible ureteroscopy (F-URS) or extracorporeal shock wave lithotripsy (SWL) between January 2009 and December 2012 were examined. Retreatment rates, complications, changes in estimated glomerular filtration rates (eGFRs), chronic kidney disease (CKD) stages, and stone-free rates were compared between the two groups. Results: Stones of 48 patients (mean age: 48.8±15.4, range: 14-76) with solitary kidneys were treated with SWL ( n=30, 62.5%) or F-URS ( n=18, 37.5%). Patient demographics and stone related parameters were similar. The most common stone location was the pelvis in the SWL group (36.6%), whereas it was the pelvis and a calix in the F-URS group (38.8%). Complications and success rates were similar in both groups, however, patients in the SWL group needed more sessions to achieve stone clearance (2.2±0.89 vs 1.06±0.24, p=0.0001). Preoperative and postoperative eGFR and CKD stage changes were also similar. Conclusion: Both SWL and F-URS are effective and safe techniques, which can be used for the treatment of stones in patients with solitary kidneys. However, patients treated with SWL need more sessions to achieve stone clearance. [ABSTRACT FROM AUTHOR]

Purpose: To compare sulbactam-ampicillin and cefuroxime antibiotics for prophylaxis of percutaneous nephrolithotomy (PCNL) and to find out the optimal regimen for antibiotic maintenance to prevent systemic inflammatory response syndrome (SIRS). Patients and Methods: Between February 2010 and March 2011, a total of 198 patients in whom PCNL was performed were prospectively randomized into two main groups regarding the type of prophylactic antibiotic (group1: sulbactam-ampicillin, group 2: cefuroxime). Each group was further randomized according to duration of antibiotic maintenance (a: single dose prophylaxis, b: additional dose 12 hours after prophylaxis, c: beginning with prophylactic dose until the nephrostomy tube removal). Seven patients in whom purulent urine was obtained through the access needle were excluded from the study. Groups were compared in terms of stone- and operation-related factors as well as preoperative urine cultures, access cultures, stone cultures, postoperative urine cultures, and presence of SIRS. Results: A total of 191 patients (group 1: 95, group 2: 96) were evaluated. Mean patient age, body mass index, stone size, and perioperative outcomes were similar. Positive culture rates did not differ between groups. SIRS was observed in 13 (43.3%) patients in group 1 and 17 patients (56.7%) in group 2 ( P=0.44). The relation between duration of antibiotic maintenance and SIRS development was not different in each group ( P=0.95 for group 1, P: 0.39 for group 2). Urosepsis was observed in two patients, and one patient died because of septic shock. Conclusions: Sulbactam-ampicillin and cefuroxime antibiotics can be used safely for prophylaxis of PCNL. Single dose administration is sufficient. [ABSTRACT FROM AUTHOR]