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Postpercutaneous nephrolithotomy nephrostogram: is it mandatory? A single center experience.

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Postpercutaneous nephrolithotomy nephrostogram (PPNN) is not mandatory after percutaneous nephrolithotomy. Omitting this routine test reduces costs and complications without affecting patient management or outcomes.

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Area of Science:

  • Urology
  • Nephrology
  • Medical Imaging

Background:

  • Postpercutaneous nephrolithotomy nephrostogram (PPNN) is a common procedure following percutaneous nephrolithotomy (PCNL).
  • Existing literature lacks studies evaluating the necessity of PPNN in routine clinical practice.

Purpose of the Study:

  • To determine if postpercutaneous nephrolithotomy nephrostogram is a mandatory procedure.
  • To assess the added cost and morbidity associated with PPNN without providing significant clinical information.

Main Methods:

  • Prospective study conducted from 2005 to 2012.
  • Included 119 patients undergoing percutaneous nephrolithotomy by a single surgeon.
  • Postoperative nephrostogram was intentionally omitted for all patients.

Main Results:

  • Achieved complete stone clearance in 97.5% of patients.
  • Only 2.5% of patients required subsequent extracorporeal shock wave lithotripsy (ESWL).
  • No patients required a second-look PCNL or nephrostogram.

Conclusions:

  • Postpercutaneous nephrolithotomy nephrostogram increases risks of infection, complications, and costs.
  • PPNN offers no added advantage over plain X-ray KUB for patients with complete stone clearance.
  • Routine PPNN prior to PCN tube removal is not recommended.