Percutaneous nephrolithotomy with and without retrograde pyelography: preliminary results of a randomized controlled trial.

Abstract

INTRODUCTION:

Since the introduction of percutaneous nephrolithotomy (PNL), many modifications to entering the pyelocalyceal system have been made. One alternative is to insert a needle pointed to an opaque stone as a landmark. The aim of this study was to compare the outcomes of managing kidney calculi by PNL with and without retrograde pyelography.

MATERIALS AND METHODS:

In this randomized controlled trial, 55 candidates for PNL with a single opaque kidney calculus in the calyx alone, the pelvis alone, or both the calyx and the pelvis were assigned into 2 groups. Twenty-seven patients underwent PNL with a ureteral catheter, and 28 patients underwent PNL without a ureteral catheter. Clinical outcomes were compared between the 2 groups using plain radiographs taken on the first day after the procedure.

RESULTS:

Patients had similar distributions regarding sex, age, operative time, hospital stay, past surgical history on the kidneys, and stone size. There was a significantly greater decrease in postoperative hemoglobin level in patients having PNL with a ureteral catheter (P < 0.001) than in those having the procedure without a ureteral catheter. No differences were seen among patients in the 2 groups in terms of stone-free rate, and number of patients with insignificant residue, and those needing extracorporeal shock wave lithotripsy, a second PNL procedure, or transurethral lithotripsy.

CONCLUSION:

Percutaneous nephrolithotomy without ureteral catheterization has specific benefits: urine leakage is lower and there is no need to perform cystoscopy. Patients with a single kidney calculus are good candidates for PNL without previous ureteral catheter insertion.

• Authors: Ali Tabibi, Hamed Akhavizadegan, Kia Nouri Mahdavi, Mohammad Najafi Semnani, Mojgan Karbakhsh Davari, Ali Reza Niroomand
• Journal: Urology journal (Urol J) Vol. 2 Issue 3 Pg. 132-5; discussion 135-6 ( 2005) ISSN: 1735-1308 [Print] Iran
• PMID: 17602415 (Publication Type: Journal Article)