Tubeless percutaneous nephrolithotomy in selected patients: A prospective randomized comparison

Tefekli A., Altunrende F., Tepeler K., Tas A., Aydin S., Muslumanoglu A. Y.

International Urology and Nephrology, vol.39, no.1, pp.57-63, 2007 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 39 Issue: 1
  • Publication Date: 2007
  • Doi Number: 10.1007/s11255-006-9040-6
  • Journal Name: International Urology and Nephrology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.57-63
  • Keywords: kidney stones, percutaneous nephrolithotomy, nephrostomy tube, analgesia, hospitalization
  • Istanbul Medipol University Affiliated: No


Objectives: To prospectively compare the outcome of standard and tubeless percutaneous nephrolithotomy (PNL) in a selected group of patients with renal stones. Methods: Patients with simple, isolated renal pelvis or lower pole caliceal stones and no significant hydronephrosis were randomly enrolled to undergo either standard PNL, in which routine nephrostomy tube was placed at the end of operation, or tubeless PNL. Occurrence of intraoperative complications, total operative time exceeding 2 h, indication for additional access or second-look PNL due to residual stones were exclusion criteria. Results: There were 11 isolated lower pole caliceal stones (mean stone burden: 3.1 cm2) and 6 isolated renal pelvis stones (mean stone burden: 2.8 cm2) in the tubeless PNL group (n : 17), and 9 isolated lower pole caliceal stones (mean stone burden: 3.4 cm2) and 9 isolated renal pelvis stones (mean stone burden: 3.1 cm2) in the standard PNL group (n : 18). Mean operation time was 9.6 ± 9.1 (range: 50-90) min in the tubeless group, and 67.3 ± 10.1 (range: 60-115) min in the standard PNL group (P > 0.05). Successful stone removal was achieved in all patients, and no significant complication was observed in any case. The mean postoperative analgesic requirement was significantly less in the tubeless group (P < 0.05). Mean hospital stay was 1.6 ± 0.4 (range: 1-3) days in the tubeless group, and 2.8 ± 0.9 (range: 2-4) days in the former group (P > 0.05). Conclusion: Our results indicate that tubeless PNL is safe in the management of selected patients and that mean analgesic requirement as well as hospitalization time is diminished with this modification. © Springer Science+Business Media B.V. 2006.