Novel Irrigation Protocol for Renal Pelvis Sterilization During Percutaneous Nephrolithotomy: A Pilot Study

Area of Science:

• Urology
• Infectious Diseases

Background:

• Percutaneous nephrolithotomy (PCNL) is the standard treatment for kidney stones larger than 2 cm.
• Infectious complications following PCNL range from 5% to 32%.

Purpose of the Study:

• To present a novel technique for improving collecting system sterility during PCNL.
• To evaluate the initial postoperative outcomes and safety of this new sterilization method.

Main Methods:

• A retrospective analysis of 56 patients undergoing PCNL between February and July 2019.
• A novel protocol involving intrarenal instillation of betadine and antibiotic (gentamicin) irrigation was used.
• Urine cultures were taken, and betadine was instilled into the collecting system before standard PCNL.

Main Results:

• The technique was applied to patients with large kidney stones (70% >2 cm).
• Only 11% of patients developed fever, and 3% had positive blood cultures postoperatively.
• No adverse reactions to the betadine or antibiotic irrigation were reported.

Conclusions:

• The novel technique of intrarenal betadine instillation and antibiotic irrigation appears safe and feasible for enhancing collecting system sterility during PCNL.
• This method shows potential for reducing infectious complications in patients undergoing PCNL for large kidney stones.