Urologists versus radiologists made PCNL tracts: the UK experience

Abstract

We aim to explore the practice of who makes the PCNL tract in the U.K. and Northern Ireland as well as presenting our data for two different approaches to PCNL tracts in Northern Ireland. A national questionnaire survey was carried out across the National Health Services hospitals in U.K. In addition, a retrospective analysis of 134 PCNL cases was carried out. Group I included 103 (77%) cases with urologist-made tracts, while group II included 31 (23%) cases with radiologists-made tracts. The survey suggested that 45% (42) of the hospitals adopted a radiologist-made tract, 44% (41) use urologist-made tract, while the remaining 11% (11) use both. Most of the radiologists' performed tracts in our series were for complex cases. Failed access occurred in 6 (5.8%) in group I and none in Group II. The overall stone-free rate was 92 and 50% for group I and II, respectively. There is a better stone clearance rate in Group I (p = 0.0016). This however is likely to be attributed to the complexity of the cases in group II. However, urologist made percutaneous tract is safe and efficacious but a team approach with radiology is needed for more complex cases.

Percutaneous nephrolithotomy access by urologist or interventional radiologist: practice and outcomes in the UK

“…We found that only a very small proportion of PCNL procedures (~1%) were abandoned because of failed renal access. This failed access rate compares favourably with those previously reported elsewhere .…”

Renal access in PNL under sonographic guidance: Do we really need to insert an open end ureteral catheter in dilated renal systems? A prospective randomized study

“…However, despite the high stone free rates obtained in a single session; PNL could be associated with certain types of complications like bleeding, organ perforation and sepsis (12). Such complications could be encountered during all steps of PNL among which the access to the renal collecting system seems to be the most important one (13). Related to this subject, an appropriate initial puncture of the most desirable calyx of the kidney is extremely important for a successful and safe procedure by limiting the chance of both bleeding as well as injury to the surrounding organs (e.g.…”

Frequency of Blood Transfusion in Percutaneous Nephrolithotomy

“…In percutaneous nephrolithotomy (PNL), the percutaneous technique of insertion of a small-caliber nephrostomy tube is used to access the kidney and drain an obstructed renal unit. Ever since its discovery, the percutaneous removal of kidney stone has replaced open techniques and is now being used with extracorporeal shockwave lithotripsy (SWL) in the clinical setting [1]. These newer techniques are far less invasive than open surgery.…”