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Current practices in percutaneous nephrolithotomy among endourologists.

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Most urologists performing percutaneous nephrolithotomy (PCNL) obtain their own access, with fellowship-trained specialists more likely to do so. Prone positioning is common, and the tubeless approach for PCNL is rarely used.

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Area of Science:

  • Urology
  • Endourology
  • Surgical Techniques

Background:

  • Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
  • Current practices and variations in PCNL technique require characterization.

Purpose of the Study:

  • To characterize current percutaneous nephrolithotomy (PCNL) practices among endourologists.
  • To analyze PCNL techniques based on practice setting, experience, and fellowship training.

Main Methods:

  • An internet survey was distributed to active Endourological Society members.
  • Responses were analyzed based on practice demographics and PCNL technique details.
  • Statistical analysis was performed to compare different groups.

Main Results:

  • A majority of respondents (74%) were in academic urology settings, with most having 11-20 years of experience.
  • Seventy-seven percent of urologists obtained their own access for PCNL, with fellowship-trained individuals more likely to do so (82%).
  • Prone positioning (86%) and an antegrade approach (68%) were predominant; nephrostomy tubes were used postoperatively by 76%, with "tubeless" PCNL performed in only 2%.

Conclusions:

  • Endourological Society members predominantly perform their own PCNL access, particularly fellowship-trained urologists.
  • Prone positioning is the standard for PCNL access.
  • Postoperative nephrostomy tube placement is common, indicating the "tubeless" approach remains infrequent.