Comparison of Percutaneous Nephrolithotomy Success Rate and Complications in Patients with a History of Different Therapeutic Interventions for Kidney Stone

Abstract

Background: Percutaneous nephrolithotomy (PCNL) is one of the five interventions offered to patients with renal stones. Objectives: This study compared the effects of previous therapeutic interventions for renal stones on subsequent PCNL regarding success rate and complications. Methods: In this descriptive-analytical study, the data from 375 patients who had undergone PCNL were reviewed retrospectively. Patients were categorized into four groups based on their previous therapeutic interventions as no history of open renal stone surgery (n = 196), PCNL (n = 64), extracorporeal shockwave lithotripsy (ESWL) (n = 88), and open surgery (n = 27). We compared surgery duration, the surgical procedure's success rate, complications, as well as the site and size of the stone between the groups. Results: The mean operation duration was significantly longer in the fourth group (61.66 ± 19.85), while there were no statistically significant differences in surgery duration between other groups (P = 0.88). The mean hospital stay, stone size, and site were also similar between the groups. All groups had a high number of pelvic stones, and the rate of upper calyceal stones was higher than middle calyceal and ureteral stones in all groups. Access time was higher in groups one and four, but no significant difference was observed (P = 0.31). Grade 1 and 2 complications were frequent among the patients. The overall immediate success rate was high in all groups. Conclusions: The present study indicates that patients with a history of open surgery for kidney-related conditions may have higher blood loss and longer surgery duration, likely due to anatomical and histological changes in the kidney.