both AUA and EAU guidelines offer a detailed, evidence-based framework to guide the urologists in the management of stone diseases. Although some discrepancies exist, particularly regarding the choice of surgical management in specific scenarios, there is generally a consensus between both the groups. However, the guidelines are not applicable to every clinical situation and need to be used in conjunction with the most recently published material and tailored to each individual patient.
Post‑PCNL complications are more commonly found in patients with history of preoperative UTI, previous history of renal surgeries, large stone burden, operative procedure more than 90 min, and presence of residual calculi.
In the present study, several factors appear to affect post‑PCNL prolonged urinary leakage. We suggest that patients who are at increased risk of prolonged urinary leakage double‑J stent should be placed at the end of PCNL procedure.
Percutaneous nephrolithotomy is a safe and effective treatment for renal stone disease. Body mass index does not affect the success or complication rate in PNL.
Stone location, stone burden, and presence of hydronephrosis detected with NCCT were factors affecting PCNL outcome. Stone density values did not correlate with the rate of bleeding or success of PCNL. PT measured by NCCT may predict bleeding and may guide surgeons in determining preoperative blood requirements. The outcome of PCNL appeared to be better in patients with thicker renal parenchyma and should be taken into consideration in the clinical evaluation of patients undergoing PCNL.
The absence of staghorn calculi and a no or mild hydronephrosis were related to an increased risk of post-percutaneous nephrolithotomy severe bleeding complications.
Optical puncture combined with balloon dilation PCNL could be associated with good therapeutic effect and low frequency of complications for the treatment of kidney stones without hydronephrosis.
UHCT is the most sensitive diagnostic tool for detecting RFs after PNL. It has higher sensitivity regardless of stone size compared to KUB and US. Additionally UHCT has higher capability of predicting occurrence of stone related events.
Superior calyceal access is a safe and most efficacious in terms of achieving complete stone clearance rate with reduced operative time, minimal blood loss, less need for a second puncture and auxiliary procedures at minimal complications.
we examine recent developments in percutaneous stone surgery, including advances in diagnosis and preoperative planning, renal access, patient position, tract dilation, nephroscopes, lithotripsy, exit strategies, and post-operative antibiotic prophylaxis.
Regional anesthesia is as effective as general anesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays and lower rates of postoperative fever
Mini‑PCNL is an effective and safe treatment option for patients with large renal stones (>20 mm). Stones located in multiple sites is the only predictor of significant residual stones.
