Retrograde percutaneous nephrolithotomy: urological treatment of a urological problem

We present our experience during a 22-month period with the retrograde approach to gain renal access for percutaneous stone removal in 71 consecutive patients. The retrograde puncture technique is fast and accurate, and it allows the physician to perform a 1-stage operation, saving the patient time, frustration and expense. The Lawson technique was used in all patients and it was successful in all but 2. In those 2 patients the Hawkins-Hunter technique was successful. There were no intraoperative or postoperative complications related to this approach. Except for 1 patient who suffered a post-procedure pulmonary embolus, no transfusions were required. The targeted stone was removed in 1 procedure in 61 of 71 patients (86 per cent). Ten patients required another procedure to remove the targeted stone or a second stone. Percutaneous procedures still are required for certain stone problems or when extracorporeal shock wave lithotripsy is not readily available. The ability of the urologist to perform this easy procedure will allow him more choice in how to manage stone patients.