Percutaneous Nephrolithotomy: Complication and Management

Yoo, Seong Ha; Lee, Tchun Yong

Abstract

Of 105 patients who underwent percutaneous nephrolithotomy (PNL) for 10 years, 22.9% had complications. Major complications were severe hemorrhage (6cases), renal pelvis perforation (2cases), ureteral perforation (1case) and pyonephrosis (1case). The patients with severe hemorrhage were treated with nephrectomy (1case), transarterial embolization (1case) and transfusion (4cases, 5pints or more). All the cases with pelvis perforation were treated with primary repair. And the patient with postoperative pyonephrosis required nephrectomy Minor complications included hemorrhage (4cases), urinary tract infection (5cases), paralytic ileus (2cases) and fever (3cases), which were treated with conservative managements. We compared the success and complication rates between early and late 5-year periods. The success rates in the early and late periods were 82.0% and 92.7%, respectively. On the other hand, the complication rates in the early and late periods were 30.0% and 16.4%, respectively Thus we conclude that PNL must be included in the effective treatment of upper urinary tract stone disease if experiences and operation technique for PNL were accumulated and appropriate therapy for the complications were taken.