The applicability of percutaneous nephrolithotomy in provincial state hospitals: the experience of the State Hospital of Mu in first 100 cases

Objective: We aimed to evaluate if percutaneous nephrolithotomy (PCN) operation, which is commonly and successfully performed in current practice, could be performed in provincial state hospitals of Turkey.

Materials and methods: Between March 2008-June 2010, 100 PCN operations, which were performed in Urology Clinic of The State Hospital of MUŞ, were retrospectively evaluated. All patients were assessed by routine urine test, urine culture, serum biochemical and coagulation tests, direct urinary system radiography (DUSR) and ultrasonography. In 2nd or 3rd days after the operation, all patients were undergone DUSR routinely. If a patients had significant residual stone ≥4 mm, the patient was directed towards extracorporeal shock wave lithotripsy (ESWL) treatment.

Results: The sample included 47 women and 53 men with a mean age of 44.1 (24-63), and the mean stone burden was 4.33 (2-10) cm2. The total success rate was 86% (86). The mean operation time was 102.4 (55-210) minutes. Blood transfusion was performed in 9 cases. 4 patients had postoperatively fever >38°C were managed by follow up and antibiotherapy. Although none of the patients had intraabdominal organ injury or the requirement of open surgery, one patient had pneumothorax.

Conclusion: PCN is a successfull treatment modality that should by the first choice of the treatment of renal stones >2 cm² with higher stone free rates, lower duration of hospital stay, and acceptable complication rates. It was seen that the urologists in peripheral state hospitals could perform PCN operation with similar results to the literature, if they have adequate surgical equipment and training.