Comparison of two different tract dilatation techniques in percutaneous nephrolithotomy: Amplatz versus balloon

The aim of this study was to compare the efficacy and safety of the Amplatz dilation (AD) and balloon dilation (BD) techniques for tract dilation during percutaneous nephrolithotomy (PCNL). We retrospectively reviewed medical records of clinical data from 345 patients who underwent PCNL at the Urology Clinic of Karaman Training and Research Hospital from February 2021 to January 2025. AD was used in 119 patients and BD was used in 171 patients. Hemoglobin decrease, blood transfusion rate, glomerular filtration rate (GFR) decrease, total operation time, hospital stay, fluoroscopy time, nephrostomy removal time, success rate and complications were compared between the two groups. Similar baseline characteristics were observed in the two groups. Compared to the BD group, the operation time (40 m vs. 54 m, p = 0.002), fluoroscopy time (150 s vs. 265 s, p < 0.001) and hospital stay (4 day vs. 5 day, p = 0.009) were significantly higher in the AD group. Hemoglobin decrease (1.8 g/dl vs. 1.0 g/dl, p: 0.012) and blood transfusion rate (15.1% vs. 8.7%, p:0.036) were observed higher in the AD group than in the BD group. Additionally success rate rate was higher for BD group than Amplatz group (90.35% vs. 84.62%, p:0.015). The complication rates based on Clavien classification such as urine leakage, renal function alteration and renal pelvic perforation were similar in two groups with no significant difference. Only bleeding and blood transfusion requirement were observed to be statistically significantly higher in the AD group (14.2% vs. 8.7%, p:0.042). BD appears to be a faster, more effective, safer and superior dilatation technique than AD, whereas BD was significantly more expensive than AD. Further confirmatory research is necessary to confirm and validate these findings.