A Prospective Study to Assess the Safety, Effectiveness and Outcome of Ultra-mini-Percutaneous Nephrolithotomy Surgery in the Management of Renal Stone Disease

Abstract

Abstract Introduction: Renal stone disease is a common urological emergency. Percutaneous nephrolithotomy (PCNL) is considered the standard of care for large-volume stone disease. However, the morbidity associated with it has led the clinicians to consider the minimally invasive techniques such as mini-PCNL and ultra-mini-PCNL (UMP). Aim: This study aims to assess the efficacy and safety of UMP based on renal parenchymal tissue injury and intraoperative bleeding. The outcome of UMP based on the requirement of post-operative stenting, complication rates, incidence of residual stones, requirement of additional procedures on follow-up, duration of hospital stay and post-operative morbidity rate were also assessed. Materials and Methods: This was a prospective, hospital-based, observational study conducted in all patients who had renal stone disease with a relatively low stone volume, 5–25 mm stone size and who underwent UMP in the institution during 18 months. The data collected were statistically evaluated in terms of safety, outcome and effectiveness of UMP. Results: Of the 80 patients enrolled in this study, 62 (77.5%) were male and 18 (22.5%) were female. Complete stone clearance was achieved in 77 (95%) out of 80 patients using UMP, whereas the remaining 3 were converted into PCNL. The mean age of the patients was 49.73 ± 12.12 years. The average stone size was 11.57 ± 3.27 mm. The mean haemoglobin fall was only minimal 0.77 ± 0.71 g/dl. 96.3% of cases were stone free in the immediate post-operative period. The average pain score was 1.81 ± 0.92 on a Visual Analogue Scale of 10. The average hospital stay was 4.21 + 1.24 days. Conclusion: UMP is a technically safe, highly effective surgery for low-volume renal stone disease, with high stone clearance, lower complication rates and better patient compliance.