Percutaneous cystolithotomy with endotracheal tube tract dilation after urinary tract reconstruction

Purpose: The effectiveness of a percutaneous approach to intact removal of large calculi from the urinary reservoir after urinary tract reconstruction was reviewed. Materials and Methods: The original site of the reservoir drainage tube was used for percutaneous access. After dilation of the tract to 34F a number 10 endotracheal tube was advanced through the tract, and the balloon (diameter up to 43 mm.) was inflated. The rigid nephroscope was then passed through the tract and calculi were removed intact without the need for ultrasonic or electrohydraulic lithotripsy. Results: Removal of single or multiple reservoir calculi attempted in 4 patients was successful in 3. Patients were discharged home within 2 days. Conclusions: The technique of over dilation of the percutaneous tract allows removal of multiple large calculi in select patients without the need for lithotripsy.