One Session or Two? A Meta-Analysis of Same-Session Versus Staged Bilateral Percutaneous Nephrolithotomy

Area of Science:

• Urology
• Nephrology
• Surgical Innovation

Background:

• Bilateral complex nephrolithiasis poses significant surgical challenges.
• Percutaneous nephrolithotomy (PCNL) is the standard treatment, with staged (sPCNL) and same-session (ssPCNL) bilateral approaches available.
• ssPCNL is an emerging alternative to the traditionally favored sPCNL.

Purpose of the Study:

• To systematically compare the efficacy, safety, and efficiency of ssPCNL versus sPCNL.
• To provide evidence-based insights for clinical decision-making in managing bilateral renal stones.
• To evaluate outcomes including stone-free rates, complications, and hospital stay.

Main Methods:

• Systematic review and meta-analysis following PRISMA guidelines.
• Searched PubMed, Scopus, and Cochrane databases for comparative studies.
• Analyzed stone-free rate, minor complications, and hospital stay as primary outcomes; operative time, hemoglobin decrease, and transfusion need as secondary outcomes.

Main Results:

• No significant difference in stone-free rates or minor complications between ssPCNL and sPCNL.
• ssPCNL demonstrated a significantly shorter hospital stay (average 2.92 days reduction).
• ssPCNL was associated with reduced operative time and comparable transfusion needs.

Conclusions:

• ssPCNL is a safe, effective, and efficient alternative for bilateral renal stones.
• It achieves comparable clinical outcomes while reducing patient morbidity and healthcare burdens.
• ssPCNL should be considered for appropriately selected patients in experienced centers.