PERCUTANEOUS NEPHROLITHOTOMY FOR MANAGEMENT OF RENAL STONES, DR AZIZ UR RAHMAN EXPERIENCE AT NORTH WEST GENERAL HOSPITAL, PESHAWAR

Objective: The main aim of this study was to evaluate and to review our experience with percutaneous nephrolithotomy
in management of renal stones and compare it with international standards.
Material and Methods: From Jan 2011 till Dec 2014, 151 patients underwent percutaneous nephrolithotomy by single
surgeon and same surgical team in our hospital. Ultra sound, X-ray KUB, CT-IVU, NCCT or IVU were used for assessment
of the kidneys and stones. All the procedures were carried out in prone position, all PCNL tracks were punctured
under fluoroscopic guidance, dilated with Alken metallic telescopic or Amplatz dilators and pneumatic lithoclast was
used for lithotripsy. Stones fragments were removed by forceps and suction, 20 to 26fr Foley catheter was inserted as
nephrostomy at end of procedure when required. All patients underwent plan X-ray KUB for documentation of stone
clearance. Data analysis included length of hospital stay, age and gender of patients, stone size, location and clearance
and complications of procedure.
Results: Age range was from 3 to 71 years with mean age of (31.77 ± 15) years, 99(66%) were male and 52(34%)
were female patients. mean stone size was (2.5 0.84) cm. average hospital stay was (2.35 ± 1.5) days, 37.7%, 47.7%
and14.6% presented with right, left and bilateral renal stones respectively. 51.7% were single while 48.3% were multiple
stones and overall stone free rates were 90.2%. 4 patients needed blood transfusions due to bleeding, pleura was
injured in two patients, one patient with single kidney went into renal failure who required dialysis for several days and
then recovered smoothly and 6 (3.9%) suffered from post OP pyrexia.
Conclusion: PCNL is best treatment modality for management of renal stones with high clearance rates, minimum
complications rates, low morbidity and short hospital stay. However well-equipped specialized centers, standard urological