Is percutaneous nephrolithotomy an effective and minimally invasive technique in the treatment of staghorn kidney stones?

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Published Mar 30, 2025
https://doi.org/10.62438/tunismed.v103i4.5524
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Vol. 103 No. 4 (2025): Tunis Med Apr 2025

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Kays Chaker
Urology Department, La RABTA Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
Nader Gharbia
Urology Department, La RABTA Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
Yassine Ouanes
Urology Department, La RABTA Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
Moez Rahoui
Urology Department, La RABTA Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
Mokhtar Bibi
Urology Department, La RABTA Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
Yassine Nouira
Urology Department, La RABTA Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.

Abstract

 


Introduction: With the advent of percutaneous nephrolithotomy (PCNL), the use of traditional surgery for the treatment of staghorn kidney stones has become rarer.


Objective: The objective of this study was to report the outcomes of percutaneous nephrolithotomy in the treatment of staghorn kidney stones.


Methods: This is a retrospective longitudinal descriptive and analytical study. It included all patients treated for a staghorn stone who underwent PNL between January 2015 and December 2021.


Results: We included 44 patients. Six patients experienced intraoperative bleeding. We reported the occurrence of postoperative infectious complications in 15 patients. The stone-free rate was 42%. Predictive factors for residual fragments were complete staghorn stone (p=0.02) and large stone volume (p=0.001). Predictive factors for hemorrhagic complications were the use of anticoagulant therapy (p=0.01), renal cavity dilation (p=0.01), complete staghorn stone (p=0.02), and large stone mass (p<0.001). Predictive factors for postoperative infectious complications were diabetes (p=0.048), positive preoperative urine culture (p=0.03), renal cavity dilation (p=0.04), complete staghorn stone (p=0.02), and postoperative drainage by ureteral stent (p<0.001).


Conclusion: PCNL is a minimally invasive and effective technique when safety conditions are met, and it has become the standard in the treatment of staghorn stones.

Keywords:

Kidney stones, Percutaneous nephrolithotomy, Staghorn stones

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