Does Previous Open Nephrolithotomy or Failed Extracorporeal Shock Wave Lithotripsy Therapy Affect Percutaneous Nephrolithotomy Performance and Outcome?

Abstract

Objective:This study aimed to summarize our experience with patients undergoing percutaneous nephrolithotomy (PNL) with a previous history of extracorporeal shock wave lithotripsy (ESWL) treatment or open nephrolithotomy and compare them with patients who underwent PNL alone.Materials and Methods:A total of 565 patients were treated with PNL from 2012 to 2022 at our center. These patients who underwent PNL were divided into three groups: Group 1 consisted of patients who had no medical history of previous ESWL or open kidney stone surgery, Group 2 consisted of those who had a history of previous ESWL, and Group 3 included patients with a history of previous open kidney stone surgery.Results:Regarding age, there were no notable differences between the three groups, body mass index, gender, laterality, and stone density in Hounsfield Units. Group 3 had a significantly higher total operation fluoroscopy time than the other two groups, and Group 2 had a significantly lower total operation time than the other two groups. Regarding the postoperative parameters of all three groups, including hospital stay, time to nephrostomy removal, urinary leakage, hemoglobin decrease, blood transfusion, and stone-free rates, no statistically significant differences were found.Conclusion:Our study demonstrates that PNL can be safely performed with a similar success rate and without a higher risk of problems in patients who have undergone open nephrolithomy or ESWL, as well as in primary PNL patients who have not undergone any previous interventions.

Keywords

• kidney stones
• open stone surgery
• extracorporeal shock wave lithotripsy
• percutaneous nephrolithotomy