Nephroscopy in Stone Surgery

Summary— We present the results of our experience with the use of the nephroscope in 130 open procedures for removal of renal stones. The Storz rigid instrument was used and permitted visualisation of approximately 60% of calices and frequent identification of small stone fragments which would not otherwise have been seen. In 32 patients biopsies were taken on papillary epithelium. In 8, plaques of subepithelial calcification were identified. These were macroscopically obvious and widely distributed over the caliceal epithelium. A high proportion of the biopsies (66%) showed a chronic inflammatory cellular infiltrate which was not necessarily related to urinary infection. Such generalised changes again indicate the futility of partial resection in the management of renal stone disease.