Postoperative Outcomes after Tubeless, Totally Tubeless, Standard, and Standard with Ureteral Stent Percutaneous Nephrolithotomy: A Nationwide Retrospective Study in Japan

Abstract

Objectives: We examined the advantages of tubeless percutaneous nephrolithotomy (PCNL) and totally tubeless PCNL over standard PCNL. Materials and Methods: Using a nationwide inpatient database in Japan, we gathered data on patients undergoing PCNL from July 2010 to March 2016 and extracted eligible patients who were candidates for tubeless PCNL. Eligible patients were divided into 4 groups: tubeless, totally tubeless, standard, and standard PCNL with ureteral stent (US). Multivariable analyses compared postoperative hospital stay, duration of analgesic use, urinary tract infection (UTI), and blood transfusion among the 4 groups. Results: Analyses were conducted on patients in the standard (n = 954), tubeless (n = 98), totally tubeless (n = 146), and standard PCNL with US (n = 389) groups. Postoperative hospital stay was significantly shorter in the tubeless group than in the standard group (1.6 days [–2.9 to 0.4]). With reference to the standard PCNL group, there was no significant difference in the number of days of analgesic use or the proportions of postoperative UTIs or blood transfusion among the groups. Postoperative UTIs developed significantly more often in women than in men regardless of the PCNL method. Conclusions: Our multivariable analyses showed that tubeless PCNL was associated with shorter postoperative hospital stays, but totally tubeless PCNL was not.