A comparison of balloon and amplatz dilators in percutaneous nephrolithotomy: a retrospective evaluation

Objective: In this study, we compared our experience using balloon and amplatz dilatation in percutaneous nephrolithotomy (PCNL). We also evaluated peri-operative and postoperative variables, including success rates.

Material and methods: Two hundred renal stone patients (123 men/77 women) underwent PCNL at the Urology Clinic of İzmir Atatürk Training and Researching Hospital from September 2005 to May 2011. The nephrostomy tract was dilated using a balloon (128 patients) or amplatz (72 patients) dilator. The groups were compared by age, total operating time, treatment success rate, retreatment rate, pre- and postoperative hematocrit values, the mean decrease in hematocrit values, blood transfusion rate, stone burden, tract dilatation failure, hospital stay and nephrostomy removal times, stone localization, previous stone operation and the cost of the dilatation system.

Results: There was no statistically significant difference in the operative time (97.9±45.3 minutes in balloon group vs. 98.5±43.4 minutes in amplatz group; p=0.43), preoperative hematocrit value (39.04±4.21 vs. 38.94±4.49; p=0.87), postoperative hematocrit value (32.74±4.86 vs. 32.48±5.43; p=0.73), hematocrit decrease (6.30±2.60 vs. 6.45±2.64; p=0.68), blood transfusion rate (15.6% vs. 16.7%; p=0.84) or treatment success rate (78.9% vs. 79.2%; p=0.96) between balloon and amplatz groups. Differences in other variables were also not observed between the two groups.

Conclusion: The balloon dilator and amplatz dilator have similar results with regard to efficacy, speed, and safety. However, the cost of the balloon dilator is higher than that of the amplatz dilator.