Percutaneous Nephrolithotomy Sequel and Complications: Comparative Study of Two Groups of Patients in Al Nasiriyah Urology Centre

Abstract

Background: Urolithiasis is a very common renal diseases.The management of patients that suffering from urinary tract calculi may considered to be a health care difficult because of its prevalence and recurrence Aim: To compare the PCNL efficiency and complications in two groups of  patients, one group without history of previous  renal stone surgery,  and other group with recurrent renal stone after previous PCNL or open surgery . Materials and methods: A cross-sectional study that extended between January of 2019 till the March of   2021, in  Al Hussain Teaching Hospital  , Thi-Qar governorate,    involving 65 patients,  when they underwent PNCL . 40 cases classified  as  primary PNCL ( patient had no previous renal surgery), and the rest of the cases (25 cases) are classified as secondary PNCL. These  total  cases had been assessed for their age, gender, body mass index, stone criteria (in form of location, size, site, opacification) .The outcome also assessed in form of operative time,  hospital stay, stone clearance, average hemoglobin drop, development of Pseudo aneurysm, pelvic  injury,  fever postoperatively and whether the patient require blood transfusion or no. Results: Even though male constituting a largest number   among study population of the two group, but there was no significant statistical difference their distribution according to the types ,  where p value less than 0. 05.  As a clinical criteria regarding the distribution of the sites , locations of the stones and stone opacity according to the types of surgical intervention, there was no significant statistical difference. As an acute and late complication, there was significant statistical difference in the blood transfusion and post-operative fever,  it was undependable because of the small number of the cases exposed to such complication .Operative time was significally shorter in primary group ,also stone free rate was significantly better in primary PCNL. Conclusions:   PCNL is effective and safe surgery ,done without fear of failure or higher risk of complications .Previous renal surgery either open or PCNL  not significantly affect outcome of surgery