الفهرس 
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Abstract
The incidence of urolithiasis in anomalous kidneys is higher than in normal kidney, as these conditions lead to impaired urine drainage and urinary stasis as well as an increased incidence of upper urinary tract infection. The anatomy and location of these kidneys makes the management of urolithiasis challenging. Many of those patients have been historically treated with open surgery. However nowadays various minimally invasive modalities for stone treatment are used in those patients, such as, PNL, mini-perc, ultramini-perc, micro-perc, extracorporeal SWL and f-URS with reported variable stone free rates. Other possible available treatment options are laparoscopic-assisted PNL and laparoscopic pyelolithotomy.
The aim of work was to report our single center experience in comparing mini-percutaneous nephrolithotomy versus flexible ureterorenoscopy for management of renal stones up to 2 cm in anomalous kidneys.
This study was prospectively conducted on (60) patients with anomalous kidneys and having solitary renal calculus up to 2 centimeters in maximum diameter presented to the Department of Genitourinary Surgery, Alexandria Main University Hospital from May 2018 to August 2020.
The patients were randomly assigned by simple randomization method to group A (30 patients prone mini-perc) and group B (30 patients F-URS) using numbered opaque envelopes picked up by a nurse at the time of operation.
Mean stone size was significantly higher in the mini-perc group (17.90 mm) than in flexible ureterorenoscopy group (14.97mm) (p<0.001). Mean operative time (80.33 min vs 56.43 min) and fluoroscopy exposure time (4.49 min vs 0.84 min) were significantly higher in the mini-percutaneous nephrolithotomy group than in the flexible ureterorenoscopy group (p<0.001). The mean post-operative DROP in hemoglobin concentration was significantly higher in the mini-percutaneous nephrolithotomy group (0.47 gm versus 0.2 gm) (p<0.001). Stone free rate after 12 weeks follow up was not statistically significant between the 2 groups (90% in mini-percutaneous nephrolithotomy vs 80% in flexible ureterorenoscopy) (FEp= 0.472).
Both modalities were found to be safe and effective for treatment of stones less than 2cm in anomalous kidneys.