Even appropriately treated preoperative urinary infections may not prevent infected urine at percutaneous nephrolithotomy. Renal pelvic urine and stone cultures may be the only way to identify the causative organism and direct antimicrobial therapy. We recommend collecting pelvic urine and stone cultures to identify the offending organism in patients at risk for sepsis, particularly those with a large stone burden requiring multiple access tracts.

Although performance scores were less in the dVT compared with the dVSSS, both simulators demonstrate good content and construct validity. The simulators appear to be equivalent for assessing surgeon proficiency and either can be used for robotic skills training with self-assessment feedback.

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The V-Loc suture is associated with a significantly shorter time for the RSR and UVA compared with the traditional suture and is not associated with a higher incidence of clinical urinary leak; however, a larger randomized study with long-term follow-up is necessary to confirm these results.

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