Percutaneous nephrolithotomy in 86 patients: analysis of results and costs

We reviewed the hospital records of the first 86 patients having percutaneous nephrolithotomy at University Hospital (Birmingham, Ala) between 1983 and 1985. Variables such as stone location, chemical composition of the stone, history of previous renal surgery, and stone size were examined to determine their effect on complication rate, overall success of stone removal, and hospital cost. The overall success rate for the removal of targeted calculi was 94%. In patients with calculi larger than 1.2 cm, the initial success rate was 63%; such patients often required a second procedure. The mean hospital stay for patients with calcium-containing calculi was 6.8 days (mean hospital cost $5,311). Patients with infection-induced calculi had a mean stay of 11.2 days (mean cost $9,362). Compared with the costs of open surgical procedures for stone removal at our institution, percutaneous nephrolithotomy was 46% less expensive. Complications were minimal in most patients, and no patient required open surgical intervention. Percutaneous nephrolithotomy is an effective procedure for removing renal and ureteral calculi. It is associated with low morbidity and is less expensive than open surgical lithotomy procedures.