The effect of stone localization on the success and complication rates of percutaneous nephrolithotomy

To evaluate the effect of stone localization on the success and complication rates of the percutaneous nephrolithotomy (PNL) procedure.

Five hundred seventy-eight PNL procedures that were performed in our clinic were retrospectively evaluated. The patients were divided into seven groups according to the localization of the renal stones as: group 1, patients having stones only in the upper calyx; group 2, patients having stones only in the pelvis; group 3, patients having stones only in the lower calyx; group 4, patients having partial staghorn stones; group 5, patients having multiple calyx stones; group 6, patients having stones in both the pelvis and lower calyx and group 7, patients having complete staghorn stones. The first three groups were defined as simple stones, and the other four groups were defined as complex stones.

The mean stone clearance rate was 77% in simple stones and 53% in complex stones (P = .005). The complication rate was significantly higher only in the group with complex staghorn stones at a rate of 19.5% (P = .006). The difference between preoperative and postoperative hematocrit concentrations was the least in the group that had stones in the pelvis and this value was statistically significantly lower than the patients with complex staghorn stones (P = .027). The mean duration of the operation and the number of ports was higher in patients with complex stones.

The localization of stone affects the success and complication rates of the operation.