Applicability of percutaneous nephrolithotomy operation in a county State Hospital

Abstract

To evaluate percutaneous nephrolithotomy (PNL) operation, which is widely used and successfully performed in current practice, its applicability in district hospitals and to present the results of our operations. Between March 2014-2016, 32 PNL operations, which were performed in Urology Clinic of the Silvan County State Hospital, were retrospectively evaluated. All patients were assessed by routine urine tests, serum biochemical and coagulation tests, ultrasonography and computerized tomography. All operations were done by the same surgeon and performed at prone position under epidural or general anesthesia. Age, sex, stone size, laterality, operative time, fluoroscopy time, complications, stone-free rate were recorded. The sample included 17 women and 15 men with a mean age of 24.6 (11-42), and the mean stone size was 3.05 (2-5) cm. 29 patients had kidney stone (16 left-13 right) and 3 patients had proximal ureteral calculi. Incomplete duplex system was present in 6 patients. The total success rate was 93.75%. The mean operative time was 56 (28-120) minutes and mean hospitalization time was 2.6 (2-4) days. The operation failed in two patients. Blood transfusion was performed in 1 case (3.1 %). 4 patients who had postoperative hematuria were managed conservatively. However, none of the patients had intraabdominal organ injuries or required open surgery. PNL, which has become the gold standard in the treatment of large kidney stones, may be applied with similar success and complication rates of the literature, despite some difficulties arising from limited facilities in peripheral state hospitals.