Related Experiment Video
Updated: Jun 2, 2026
03:56
A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
The debate over percutaneous nephrolithotomy positioning: a comprehensive review
Brian Duty1, Zhamshid Okhunov, Arthur Smith
1Department of Urology, Long Island Jewish Health System, New Hyde Park, New York, USA.
The Journal of Urology
|May 17, 2011
Summary
Both prone and supine percutaneous nephrolithotomy are feasible. Further randomized trials are necessary to definitively compare their efficacy and safety for kidney stone removal.
Area of Science:
- Urology
- Minimally Invasive Surgery
Background:
- Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
- The choice between prone and supine positioning for PCNL remains debated.
Purpose of the Study:
- To review the advantages and disadvantages of prone versus supine PCNL.
- To identify clinical factors that might favor one position over the other.
Main Methods:
- Literature search of PubMed for articles published since 1998.
- Included studies on anesthesia, organ movement, and PCNL case series.
Main Results:
- Prone position: decreased cardiac index, increased lung capacity, greater access surface area. Supine position: increased risk of liver/spleen injury (upper pole), potential colon injury (prone, lower pole), decreased surgeon radiation, spontaneous stone drainage, shorter operative time in comparative studies.
- Non-comparative series suggest prone PCNL may reduce operative time and blood loss for staghorn calculi.
Conclusions:
- Both prone and supine PCNL are viable options.
- More randomized controlled trials are required to establish definitive efficacy and morbidity differences.
Related Concept Videos
01:25Urinary 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...
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:30Urinary Tract Calculi III: Medical Management
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
01:28Imaging Studies I: Kidney, Ureter, and Bladder Studies
Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
01:28Urinary Tract Calculi V: Nursing Management
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...