Efficacy and Safety of Simultaneous Bilateral Tubeless PCNL

PCNL Bilateral Tubeless Staged

Authors

  • Dr. Raed Hmood Afiet MD CABMS Urology Endourologist & Kidney Transplant Surgeon. Medical City Complex, Surgical Specialties Hospital, Urology Department, Baghdad, Iraq
  • Dr. Ihab Saad Khewkah MD FRCS Urology CABMS Urology FIBMS Urology Endourologist. Al-Yarmouk Teaching Hospital, Urology Department, Baghdad, Iraq
  • Dr. Haidar Hazim Al-Jabban MD CABMS Urology Endourologist. Al-Yarmouk Teaching Hospital, Urology Department, Baghdad, Iraq
Vol. 3 No. 4 (2025): International Journal of Integrative and Modern Medicine
Articles
April 23, 2025

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Background: Patients burdened with bilateral kidney stones are challenging cases for endourologists. Multiple and bilateral renal stones incidence is increasing, being reported in 15% of patients. In cases with bilateral renal stones, PCNL may be performed in a single session as a synchronous bilateral PCNL (SBPCNL) or as a planned staged procedure. Improvement in PCNL technique, marked reduction in morbidity, shorter operative time, hospital stay, and improvement in stone clearance encouraged the introduction of SBPCNL.

Aims of the study: is to evaluate the impact of SBPCNL on complication rate and stone-free status.

Patients and methods: From December 2021 to October 2023, 116 patients with bilateral renal stones were selected to undergo PCNL and prospectively followed up.

These patients were divided into two groups

  • Group A, Tubeless SBPCNL, was done.
  • Group B, staged tubeless PCNL, was done.

The groups were compared for stone-free status, operative times, post-operative hematocrit drop, creatinine level rise, need for additional analgesia, and any other postoperative events.

Results: One hundred and sixteen patients with bilateral renal stones were divided into two groups: group A (62 patients) and group B (54 patients). Group A patients showed statistically significant higher operative times (77.12 (±19.9)) compared to group B patients (59.72 (±19.8)). In addition, group A patients required more analgesic medications (17.75%) than group B patients (5.55%). This difference was statistically significant also. The stone-free rate, hematocrit drop, infection rate, and creatinine level rise showed comparable results between groups.

Conclusion: SBPCNL is a safe procedure, showing a comparable stone-free rate to a staged procedure as well as a comparable complication rate. However, SBPCNL showed statistically significant higher operative time and use of extra analgesia when compared to staged PCNL.