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Percutaneous nephrolithotomy in the supine position: technical aspects and functional outcome compared with the prone
Ahmed M Shoma1, Ibrahim Eraky, Mahmoud R El-Kenawy
1Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Objectives:
To compare the results of percutaneous nephrolithotomy in the supine and prone positions.
Methods:
A total of 130 patients who underwent percutaneous nephrolithotomy for renal or upper ureteral stones were evaluated in a prospective and nonrandomized manner. The procedure was carried out in the supine or prone position in 53 and 77 patients, respectively. The results in both positions were compared regarding the technical aspects, success rate, and morbidity.
Results:
Regardless of the position, the pelvicaliceal system could be successfully approached in all patients, and the posterior calices were the most common site of entry. Punctures through the anterior calices were more frequently reported with the supine position. A higher incidence of anteromedial displacement of the kidney during tract dilation was reported with the supine approach. The overall success rate was 89% and 84% in the supine and prone positions, respectively. The complication rates were similar in both groups, and none of the patients experienced injury of adjacent organs.
Conclusions:
The approach to the pelvicaliceal system is feasible in the supine position. The success and complication rates are comparable to the prone approach.