Simultaneous Bilateral Percutaneous Nephrolithotomy: A Single-Center Experience

Abstract

To evaluate the safety and efficacy of simultaneous bilateral percutaneous nephrolithotomy (SBPCNL) for bilateral renal calculus disease. A retrospective study was conducted from June 1996 to February 2006 involving 38 male and 7 female patients with a mean age of 44 years (range 5-73 years) with 90 affected renal units who underwent SBPCNL under general anesthesia. Those patients with established nephrostomy tracts were excluded from the study group. The average duration of the procedure was 107 +/- 43 minutes (range 60-220 minutes). The average drop in hemoglobin was 2 +/- 1.2 g/dL (range 0.3-5.6 g/dL), with 3 patients (7%) requiring blood transfusion. In 87% of patients, a single stage was performed on both sides, while 13% required two stages on one side. A single tract was on both sides utilized in 78%, while 22% of the patients required two tracts on one side. None required two tracts on both sides or more than one stage on both sides. The stone-clearance rate was 96%. The average hospital stay was 6 days. Complications consisted of renal-pelvic perforation in two patients and transient pyrexia in five. Three patients had persistent urine leak on one side, of which two stopped spontaneously and one necessitated ureteral stenting. Simultaneous bilateral PCNL is a safe procedure and can be used effectively in adults as well as in children. In addition to being cost effective, it involves only a single anesthesia with a shorter hospital stay and faster convalescence. However, patients with a large stone burden or complex pelvicaliceal anatomy should not be selected for SBPCNL.