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Urinary Tract Calculi VI: Surgical Management

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

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Tubeless percutaneous nephrolithotomy.

Madhu Sudan Agrawal¹, Mayank Agrawal

¹Department of Urology, S. N. Medical College, Agra, India.

Indian Journal of Urology : IJU : Journal of the Urological Society of India

|June 11, 2010

Summary

This summary is machine-generated.

Tubeless percutaneous nephrolithotomy (PCNL) offers a safe and effective alternative to standard PCNL, reducing pain and hospital stays. Further trials are needed for complex cases.

Keywords:

Kidney stone percutaneous nephrolithotomy tubeless

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Area of Science:

Urology
Minimally Invasive Surgery

Background:

Percutaneous nephrolithotomy (PCNL) traditionally involves a nephrostomy tube for drainage.
Recent advancements have introduced 'tubeless' PCNL, utilizing internal drainage via double-J stents or ureteral catheters.

Purpose of the Study:

To review evidence comparing the safety, effectiveness, feasibility, and advantages of tubeless PCNL against standard PCNL.
To evaluate the outcomes of nephrostomy-free PCNL procedures.

Main Methods:

A comprehensive MEDLINE database search was conducted for studies on 'tubeless' PCNL.
Cross-referencing and inclusion of non-MEDLINE indexed urology journals were performed.

Main Results:

Tubeless PCNL is generally safe, economical, and reduces postoperative pain, morbidity, and hospital stay.
The technique is effective for various stone complexities, including staghorn calculi, and in specific patient groups like children and obese individuals.

Conclusions:

Tubeless PCNL demonstrates favorable outcomes in selected patients with smaller stone burdens and uncomplicated procedures.
Further prospective randomized trials are necessary to establish evidence for extended indications like complex stones and concurrent ureteropelvic junction obstruction.