Percutaneous Nephrolithotomy: Our Initial Experience With 125 Cases

Abstract

Background 
 Percutaneous nephrolithotomy (PCNL) is generally accepted to be a minimal invasive technique with low complication rates. In the current study we reviewed our initial experience with percutaneous nephrolithotomy.
 Patients and Methods
 A prospective study of 125 patients with mean age of (34.65) years, underwent PCNL in our center from April 2009 to November 2010. PCNL done in prone position by a single experienced faculty urologists under general or spinal anesthesia under fluoroscopic guidance. The kidney was punctured via a lower pole calyx whenever possible. The demographic data, stone parameters, PCNL complications and stone-free rate were evaluated.
 Results
 One hundred twenty five patients, underwent percutaneous nephrolithotomy , 85 male and 40 female, with a mean (range) age of 34.65 (3-83) years, and a mean (range) stone size of 39,6 mm (10-80) mm. Stone-free rate after PCNL monotherapy was 81.6%, which increased to 88% with clinically insignificant small residual fragments ≤4 mm. Overall complication rate was observed in twenty six patients (20.8%). Majority were minor complications, with the most common observations of transient fever (11.2%), need for blood transfusion (5.6%), pelvic and calyceal perforations were 4%, and all managed conservatively. No death, urosepsis, nor injuries to adjacent organs were recorded.
 Conclusion
 Our data demonstrate that PCNL is a safe and effective technique. Most of the intraoperative incidents or complications are minor and easy to solve. However, an adequate training is imperative in order to reduce the associated morbidity.