Outcome of percutaneous Nephrolithotomy

ABSTRACT

To assess the implementation of Percutaneous Nephrolithotomy [PCNL] in renal stone management and evaluate the factors for efficacy and safety of PCNL. Case series. Department of Urology at Jinnah Postgraduate Medical Centre, Karachi, from January 2008 to December 2011. Patients aged above 12 years of age, irrespective of gender with normal renal function, mean stone size > 2 cm, lower pole stones > 1 cm, and ESWL failure were selected. After the procedure, on the first postoperative day, a plain abdominal radiograph was obtained to verify stone clearance. A nephrostomy tube was clamped overnight and subsequently removed when no residual stone which needs second sitting was seen. In 175 patients, 62.86% [n=110] were male and the mean age was 35 +/- 9.56 years. One hundred and seventeen [66.85%] patients were primarily stone free and 13.71% [n=24] patients needed a second look procedure, thus, a total of 80.57% [n=141] patients were stone free in the same admission. Complications included failure in 4.0% [n=7] patients, bleeding in 8.57% [n=15] patients, a small residual stone in 15.43% [n=27] patients; and puncture site pain almost in every patient. Transient fever occurred in 55.43% [n=97] patients, urinary leakage in 8.57% [n=15] patients, urinary tract infections in 5.14% [n=9] patients, ureteric colic in 3.43% [n=6] patients, colonic injury in 0.57% [n=1] patient; and nephrectomy was required in 0.57% [n=1] patient due to severe bleeding. One patient [0.57%] expired due to anaesthesia complications. Percutaneous nephrolithotomy [PCNL] has a good success rate. There is minimal blood loss, and few major complications.