Abstract
Purpose:
To evaluate the safety and efficacy of single-session supine bilateral percutaneous nephrolithotomy (BPCNL) in patients with bilateral renal stones.
Methods:
We retrospectively identified patients from February 2019 to July 2023 with bilateral renal stones measuring >2 cm and <5 cm in their maximum dimension for each side mainly located in the renal pelvis that had been treated with single-session supine BPCNL. The stone-free rate was accepted when remaining fragments of ⩽ 2 mm were discovered by a computed tomography scan.
Results:
Fifty-two patients with bilateral renal stones measuring 2:5 cm in their maximum dimension for each side who had been treated with single-session supine BPCNL were included in the study; a statistically significant difference in serum creatinine level was detected on day 1 postoperatively (p < 0.0001) compared with the baseline values that became insignificant at 1 week and 1 month postoperatively (p = 0.403 and 0.471 respectively). Also, statistically significant difference in glomerular filtration rate was detected at day 1 postoperatively (p < 0.0001) compared with the baseline values that became insignificant at 1 week and 1 month postoperatively (p = 0.95 and 0.07 respectively implicating early renal affection that shortly returned to normal values. The mean operative time for both sides was 126.5 ± 22.9 min, and the mean hemoglobin drop after the procedure was 1.9 ± 0.99 g/dl. The primary stone-free rate was 75%, with 11.6% of the remaining patients had a residual insignificant stones >2 mm but still less than 6 mm. Finally, 13.4% of the patients needed ancillary procedures.
Conclusion:
Single-session supine bilateral PCNL is both safe and effective for patients with bilateral renal stones. However, this is a complex procedure that should only be performed by expert surgeons in a tertiary centers.
Trial registration number:
(167) SPS/URS_008 retrospectively registered.
Keywords
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