Outcomes and Complications of Percutaneous Nephrolithotomy (PCNL): A Single-Center Experience

Abstract

Background: Urolithiasis is extremely prevalent in Pakistan, with percutaneous nephrolithotomy (PCNL) emerging as the primary treatment modality over traditional open surgery. Despite its effectiveness, PCNL is associated with a risk of complications and residual stones. There is limited data on PCNL outcomes from Southern Punjab, necessitating an evaluation of its efficacy and safety in this region. Methods: We conducted a retrospective analysis of 399 patients who underwent PCNL at a tertiary care hospital in Muzaffargarh, Pakistan, between October 2016 and September 2022. Detailed preoperative assessments, surgical procedures, and postoperative outcomes were reviewed. Stone clearance and complication rates were assessed, and factors influencing these outcomes were analyzed. Results: The median age of the study population was 39 years, with a male predominance. Stone clearance was achieved in 80.45% (321) of cases, with higher success rates observed in lower pole punctures. Complications occurred in 2% (13) of patients, predominantly hydrothorax following upper pole puncture. Patients with comorbidities had a higher risk of complications (P = 0.097). Residual stones were more common in staghorn stones and larger stone sizes (>3-4 cm). The median operative time was 60 minutes, shorter than reported in the literature, reflecting surgical expertise. Conclusion: PCNL is an effective and safe treatment option for urolithiasis in Southern Punjab, Pakistan, with favorable stone clearance rates and low complication rates. Tailoring treatment strategies based on patient characteristics and optimizing surgical techniques are essential for improving outcomes in this population.