Outcome of percutaneous nephrolithotomy for renal stones in Assiut Urology and Nephrology Hospital

Abstract

ContextPercutaneous nephrolithotomy (PCNL) has become the standard treatment for renal stones not amenable to extracorporeal shock wave lithotripsy in many countries.AimsThe current study aims to evaluate the outcome of PCNL, in terms of efficacy and success rate, in the management of renal stones in our hospital.Settings and designThis is a descriptive case-series study.Patients and methodsA total of 230 patients, 173 men and 57 women underwent PCNL in our hospital between September 2013 and September 2015. The following clinical parameters were reported; stone site, size, serum creatinine, operative time, site of calyceal puncture, number of tracts, decrease in hemoglobin level, length of hospital stay, stone-free rate (SFR), and complications.Statistical analysis usedIntercooled STATA, version 9.2 was used. χ-Test or Fisher's exact test was used for comparison of the categorical data and Mann–Whitney U-test used to compare the noncategorical data.ResultsThe median age was 38 years (range: 3–75 years). The mean operative time was 110 ± 30 min, and hospital stay ranged from 2 to 8 days. The primary SFR was 70.9% after the first session of PCNL but the overall clearance was 87.7%. It was found that stone location, access puncture, access number, and operative time were statistically significant factors affecting SFR. The overall complications were 13%.ConclusionPCNL is considered a standard treatment for large renal stones. Stones distribution, access puncture, number of access, and operative time significantly affect the SFR. The usage of flexible nephroscope and a second-look nephroscopy improved the outcome.