Postoperative infective complications following percutaneous nephrolithotomy

Urol Ann. 2021 Oct-Dec;13(4):340-345. doi: 10.4103/UA.UA_153_20. Epub 2021 Sep 2.


Introduction: Percutaneous nephrolithotomy (PCNL) is recommended as the first choice of therapeutic strategy for patients with renal stones larger than 2 cm. It is reported that up to one-third of patients might have some perioperative complications, especially fever and urinary tract infections, which constitutes about 21%-39.8% of all the complications.

Primary and secondary: The primary aim of the study was to study about the proportion of patients getting post-operative infective complications following PCNL. The secondary aim was to study the patient, stone and procedure related risk factors associated with the infective complications.

Settings and design: This is an institution-based observational study.

Materials and methods: All patients who underwent PCNL in the Department of Urology, Medical College, Thiruvananthapuram, during 3 years from September 2016- to August 2019, were included in the study. In this study, the demographic factors and factors related to the patient, stone, and the procedure were collected and analyzed.

Statistical analysis used: Data analysis was performed using SPSS version 22.0.

Results: During the 3-year period, a total of 201 patients with renal stones were treated with PCNL in our hospital. Of this 190 cases were taken for analysis. The mean age of patients was 47.7 years, 148 (77.9%) were male, 42 (22.1%) were female, The final outcomes evaluated were episodes of fever, documented urinary tract infection (UTI), pyelonephritis, and sepsis. Thirty-six (18.9%) patients had fever, of which 21 (11.1%) had UTI, 6 (3.1%) had pyelonephritis and 5 (2.6%) developed sepsis.

Conclusions: Post-PCNL complications are more commonly found in patients with history of preoperative UTI, previous history of renal surgeries, large stone burden, operative procedure more than 90 min, and presence of residual calculi.

Keywords: Percutaneous nephrolithotomy; pyelonephritis; sepsis; urinary tract infection.