Introduction and Objectives
Percutaneous nephrolithotomy (PCNL) is nowadays a widely practiced procedure. Despite the good stone-free rates, it still has a specific morbidity. Our goal was to describe the complications of this method on a significant series of patients.
Material and Methods
Between January 2001 and January 2009, 2115 patients (age between 18 and 81 years old) underwent PCNL (2301 procedures). We used 24 F rigid nephroscopes (2204 procedures) and 15F flexible ones (126 procedures). The mean follow-up period was 67 months (range 3 to 132 months).
Intraoperative incidents were encountered during 92 procedures (4%): losing the percutaneous traject (43 cases), poor visibility due to bleeding and imposing the termination of the procedure (35 cases) and descendant stone fragments’ migration imposing antegrade ureteroscopic removal (14 cases). The overall complications’ rate was 22% (506 cases): significant bleeding requiring blood transfusions (72 cases), nephrectomy (2 cases) or open surgical hemostasis (3 cases), sepsis (3 cases), fever (89 cases), pyelocaliceal perforations (35 cases), hemoperitoneum (1 case), persistent lumbar urinary fistulae requiring retrograde JJ ureteral stenting (299 cases) and extrarenal stone fragments migration (2 cases). However, the majority of these complications were minor. The mortality rate related to PCNL procedures was 0%.
According to our experience, PCNL is a safe and effective technique. Most of the intraoperative incidents or complications are minor and easy to solve. However, an adequate training is imperative in order to reduce the associated morbidity.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.