Vol 44 # 2 June 2012 - Kma.org.kw

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KUWAIT MEDICAL JOURNAL
June 2012
Original Article
Comparison of Changes in Body Image of Patients
with Renal Calculi Treated by Pyelolithotomy
or Percutaneous Nephrolithotomy
Erdogan Aglamis 1 , Cavit Ceylan 1 , Serkan Altinova 1 , Ege Can Serefoglu 2 , Ali Beytur 3
1
Department of Urology, Elazig Education and Research Hospital, Elazig, Turkey
2
Department of Urology, Kiziltepe State Hospital, Mardin, Turkey
3
Department of Urology, Inonu University Medical Faculty, Malatya, Turkey
ABSTRACT
Kuwait Medical Journal 2012; 44 (2): 113 - 117
Objective: To compare changes in body image of patients who
had pyelolithotomy (PYL) or percutaneous nephrolithotomy
(PNL) for kidney stones
Design: Prospective, descriptive study
Setting: Elazig Education and Research Hospital, Turkey
Subjects: A total of 69 patients, who had PNL or PYL done
for renal stones, were evaluated, prospectively.
Interventions: Patients were divided into two groups: PNL
(39 patients) and PYL (30 patients). Body dismorphic disorder
scale (BDDS) was used to measure body image changes of
these patients before, one and six months after the operation.
The patients were questioned and their answers were noted.
BDDS score was calculated according to the answers.
Main Outcome Measures: Mean BDDS scores between the
two groups were statistically compared by t-test method
Results: The difference of mean BDDS scores between
two groups before the operation, and six months after the
operation was not statistically significant (p > 0.4 and p > 0.4
respectively). However, mean BDDS scores one month after
the operation were significantly higher in PYL group and
perception of body image was worse (p = 0.01).
Conclusion: In early postoperative period, perception of
change in body image was significantly worse in the PYL
group. However, in late postoperative period, there were no
significant differences between the two groups of patients.
For these reasons, we consider that the changes in body
image should not be a determining factor for selecting the
surgical approach.
KEY WORDS: body image, percutaneous nephrolithotomy, pyelolithotomy
INTRODUCTION
The main factors that determine the treatment
method in renal stone are location, size, number of stones
and structure and anatomy of the urinary tract [1-2] . Main
surgical methods for the treatment of kidney stones
are ureterorenoscopy (URS), pyelolithotomy (PYL)
and percutaneous nephrolithotomy (PNL). After its
first application in 1976, and by the development in
instrumentation, PNL has become a standard method
of care in surgical treatment of kidney stones, with
low morbidity, short convalescence and low costs [3] .
For these reasons, open surgical procedures such as
PYL are preferred only in selected cases in developed
countries. Despite this evidence, open kidney surgery
is widely performed in many urology centers so far.
Body image changes as evaluated by the patient after
surgery, is an important factor to be considered for
choosing the surgical technique. Body image is the
individual’s perception of his own body and his own
evaluation of positive and negative feelings against his
own body parts and their functions [4] .
PYL, which leaves a large scar on the patient’s body,
can be considered to cause significant changes in body
image, while PNL which leaves a very small scar, can
be thought to cause the least change in body image.
However, effects of the preferred surgical method on
body image, is an issue to be examined separately for
each community because of different value judgments
of societies. In this study, we compared body image
and surgical techniques in patients who had PNL or
PYL for treatment of kidney stones.
SUBJECTS AND METHODS
Sixty-nine patients, who had PNL or PYL for renal
stones, were evaluated in this study. Out of the 69
patients, 39 (male / female: 29/10), hadPNL, while 30
Address correspondence to:
Erdogan Aglamis, MD, Department of Urology, Elazig Education and Research Hospital, Elazig, Turkey. Tel: +904242381000
E-Mail: uroloji23@yahoo.com