Comparative study of standard, tubeless and totally tubeless PCNL for renal stones
Percutaneous nephrolithotomy (PCNL) is the standard treatment for renal stones. To reduce the pain and morbidity after standard PCNL because of nephrostomy tubes, various modifications of PCNL are developed. We did a comparative study on standard PCNL, tubeless PCNL and totally tubeless PCNL. Materials and Methods: A total of 60 patients were randomized into three groups of 20 each: standard PCNL with nephrostomy tubes (Group 1), tubeless PCNL with ureteric stent and no nephrostomy (Group 2), and totally tubeless PCNL without ureteric catheter or nephrostomy (Group 3). The outcomes measured were hemoglobin (Hb) drop, hemorrhage, need for blood transfusion, pyrexia, urine leak, pain score, analgesic requirement, and duration of hospital stay. Results: In all the three groups, hemorrhage, Hb drop, need for blood transfusion, and postoperative pyrexia were not significantly different. Standard PCNL group had significant postoperative urinary leak which was not present in the other two groups. The analgesic requirement and duration of hospital stay of was significantly less in tubeless and totally tubeless groups compared to the standard. Conclusions: PCNL is the standard treatment for renal stones. Standard PCNL can be modified to reduce complications and early recovery. Totally tubeless PCNL significantly reduced postoperative pain, urine leak and morbidity compared to the standard PCNL.