الفهرس 
Materials and methodsOnly 14 pages are availabe for public view
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Abstract
During the period between February 1994 and April 1996, filly patients with 55 renal units, were subjected to percutaneous nephrolithotomy using combined technique of rigid and flexible nephroscopy. Thirty five were males (70%) and fifteen were females (30%). Their age ranged between 15 and 60 years.
Forty patients (80%) were presented with renal pain, 8 patients (16%) with fever and pain post ESWL and 2 patients (4%) with obstructive anauria.
In 20 renal units (34.6%) the stones were located in the upper 2/3 of the ureter, calyceal in 15 renal units (27.5%), multiple in 18 renal units (31%) and large pelvic stones in 2 renal units (6.9%).
The stones were radio-opaque in 48 renal units (87.3%) and radiolucent in 7 renal units (12.7%). In 3 renal units with multiple radiolucent stones (out of the 7 renal units) the number of stones extracted by flexible nephroscope was more than detected by ultrasound and IVU. In 2 renal units with large pelvic radiolucent stone, the ultrasound was used to disintegrate such stone and the flexible nephroscope was introduced to explore the pelvicalyceal system and several gravels were extracted from different sites.
Summary 136
Complete removal of stones were successful in 44 renal units (80%). While residual stone in 2 renal units (6.9%) who were referred for ESWL on the other hand 9 renal units (13.1%) had to open surgery.
Single puncture was sufficient in all the successful cases, the extraction was carried out mechanically in 33 renal units (75%). Whereas, combined mechanical and ultrasonic disintegration was carried in 11 renal units (25%).
The site of puncture through the middle posterior calyx was carried in 30 renal units (54.5%), posterior lower calyx in 25 renal units (45.5%).
The distribution of the calyceal stones in 55 renal units were, upper calyceal 14 renal units, middle calyceal 7 renal units and lower calyceal 12 renal units.
In the eleven cases where stones could not be retrieved (20%) the cause of failure was, failure to enter the calyx in 4 renal units (36.4%) and failure to retrieve the stone after entering the calyx in 7 renal units (63.6%).
The size of the stones was less than 1 cm for all calyceal and upper ureteral stones.
The stones in 30 renal units (68.2%) out of the 44 renal units were removed on the first session. On the other hand, in the 14 renal units (31.8%) the stone were extracted on the second session two days later.