Percutaneous nephrolithotomy in patients with or without a history of open nephrolithotomy

J Endourol. 2003 May;17(4):213-6. doi: 10.1089/089277903765444320.


Background and purpose: Whether a history of open nephrolithotomy affects the efficacy and morbidity of percutaneous interventions remains unsettled. We investigated this issue in our patients.

Patients and methods: A series of 51 men and 14 women who had undergone nephrolithotomy at least once (group A; mean age 40 years) were compared with 73 men and 44 women submitting to percutaneous nephrolithotomy (PCNL) as their first surgery (group B; mean age 43 years). All patients were operated on by the same surgeons over the same period of time. Fifty patients (81.5%) in group A harbored a single stone, whereas 35.9% of patients in group B had single stones (P < 0.001). However, the two groups were similar in terms of stone laterality, the right:left ratio being 1.03 in group A and 0.67 in group B (P = 0.22).

Results: The proportion of patients in whom PCNL failed to clear all the stones even though access was obtained did not differ in the two groups (6.15% in group A and 8.55% in group B; P = 0.77). The collecting system was inaccessible in 6.2% and 5.1% of patients, respectively (P = 0.74). Pyelonephritis or abnormal bleeding occurred in similar proportions in the two groups (P = 0.72 and P = 0.74, respectively). No other surgical complications occurred in either group.

Conclusion: A history of open nephrolithotomy does not adversely affect the efficacy or morbidity of PCNL.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Hemorrhage / etiology
  • Humans
  • Lithotripsy / adverse effects
  • Lithotripsy / methods*
  • Male
  • Middle Aged
  • Nephrostomy, Percutaneous / adverse effects
  • Nephrostomy, Percutaneous / methods*
  • Pyelonephritis / etiology
  • Treatment Outcome
  • Urinary Calculi / therapy*