Editorial Comment

Abstract

As with many other surgical disciplines, there is an impetus within the endourologic community to decrease the morbidity of surgical procedures when feasible. With regard to percutaneous renal surgery, such efforts have focused on different modalities for postoperative drainage, including smaller nephrostomy tubes, indwelling ureteral stents, or no drainage tubes or catheters altogether. The preceding article highlights in a retrospective manner that all these modalities are feasible and suggests improved morbidity in patients who are left tubeless (albeit with a ureteral stent) or totally tubeless (no adjunctive drainage measures). Such observations are similar to that described in several other series referenced within the manuscript. Although this retrospective analysis provides a valuable starting point to query such issues, the ultimate goal is to evaluate this question in a prospective manner that is less susceptible to confounding variables and biases. In that regard, there are several important points that merit consideration. Percutaneous Nephrolithotomy: Nephrostomy or Tubeless or Totally Tubeless?UrologyVol. 75Issue 5PreviewTo compare the feasibility and morbidity of tubeless, totally tubeless, and standard percutaneous nephrolithotomy (PNL) with nephrostomy tube in a single center with selected patient population. Full-Text PDF ReplyUrologyVol. 75Issue 5PreviewWe applied percutaneous nephrolithotomy (PNL) operation to 264 patients over a period of 20 months. Among these, we selected 174 patients to evaluate safety and usability of “tubeless PNL” and “totally tubeless PNL.” We compared these 2 methods with standard PNL procedure. To our knowledge, this is the first study, which compares 3 different approaches (tubeless, totally tubeless, and standard nephrostomy groups). It is obvious that it would be more valuable to perform a prospective study instead of a retrospective one. Full-Text PDF