Poster session 5: Nephrolithiasis| Volume 8, ISSUE 8, P685, September 2009

C81 Classification of percutaneous nephrolithotomy complications using the modified Clavien grading system

      Introduction and Objectives

      To report the complications after or during percutaneous nephrolithotomy (PNL), according to modified Clavien grading system.

      Material and Methods

      A total of 911 PNLs were performed between 2006 and 2008 in our clinic, and charts were retrospectively reviewed focusing on complications observed. PNL was performed in 697 cases (76.5%), ureteroscopy followed by PNL in 110 cases (12.07%) and tubeless PNL in 104 cases (11.42%). The stone free rate achieved at 3 months postoperative was 90.56% – 825 patients. According to the modified Clavien classification system, complications were stratified into five grades. Kidney and ureteral stones treated with PNL were also classified as simple (432 – 47.42%) and complex (479 – 52.58%) and complications rates were compared.


      A total of 285 complications were observed in 259 (28.43%) patients. There were 48 grade 1 (5.26%), 144 grade 2 (15.8%), 54 grade 3a (5.92%), 28 grade 3b (3.07%), 6 grade 4a (0.66%) and 2 grade 4b (0.22%) complications, and 3 deaths – grade 5 (0.33%). Most of the complications were related to bleeding and urine leakage. Grade 2 and 3a complications were significantly more common in patients with complex renal stones.


      A graded classification scheme for reporting the complications of PNL may be useful for monitoring and reporting outcomes, but for more accurate data it is necessary a prospective study.