Outcomes associated with Percutaneous Nephrolithotomy performed in the supine position.

Abstract

Background: Valdivia first reported safe percutaneous kidney access with a supine patient in 1987-1988. The supine position gained further popularity following the 2007 publication of an international study revealing the Galdakao modification. This study aimed to determine the outcomes associated with percutaneous nephrolithotomy (PCNL) performed in the supine position.

Methodology: This descriptive case series study was conducted at the Department of Urology, Sindh Institute of Urology & Transplantation (SIUT), Karachi, Pakistan, from November 7, 2019, to May 6, 2020. Patients were monitored for up to four weeks post-procedure to evaluate complications resulting from PCNL, including fever, hematuria, gross hematuria, ureteral stones, and urine extravasation.

Results: Among the 221 patients included in the study, the frequency of complications following PCNL in the supine position was as follows, fever in 27 patients (12.2%), hematuria in 30 patients (13.6%), gross hematuria in 10 patients (4.5%), ureteral stones in 2 patients (0.9%), and urine extravasation in 3 patients (1.3%). Notably, 149 patients (67.5%) experienced no complications.

Conclusion: The most frequently reported complication among patients undergoing supine PCNL was fever, followed by hematuria and gross hematuria. These findings underscore the importance of monitoring for these specific complications in clinical practice.