Journal of Urological Surgery (Sep 2023)
Evaluation of Factors Affecting Success Rate in Percutaneous Nephrolithotomy: A Five-Year Experience
Abstract
Objective:To analyze the parameters that are believed to impact the success rate in patients undergoing percutaneous nephrolithotomy and to determine the factors that have a significant effect.Materials and Methods:Success rates of 508 patients who underwent percutaneous nephrolithotomy were determined over a five-year period. Evaluation was performed with the medical history, non-contrast computerized tomography, and clinical research form in the first, third, and sixth months postoperatively. Patient characteristics, stone characteristics, and operation details were analyzed, and their effects on success were investigated. In the evaluation of the success rate, the results of the first month, were considered.Results:No significant difference was shown between the successful and unsuccessful groups in terms of demographic features. Morbidities such as body mass index, hypertension, diabetes mellitus, hyperlipidemia, and heart disease had no effect on success. Solitary kidney or congenital renal anomaly, degree of hydronephrosis, and high preoperative serum urea creatinine levels did not have a significant impact on the success rate. Significant effects of parameters such as stone volume greater than 15 cm2, complex stones, infection and cystine stones, intraoperative complication rate, and operation time on success were investigated (p<0.001, p=0.038, p=0.014, p=0.010, p=0.022, p=0.030, respectively). Success rates decreased statistically in cases with accompanying macroscopic hematuria (p=0.032). Previous surgery, extracorporeal shock wave lithotripsy history, and multifocal access had no effect however surgical experience increased the success rate (p=0.036).Conclusion:The success rates in percutaneous nephrolithotomy can be enhanced by examining the factors that may have an impact and taking necessary precautions relevant to these factors.
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