Simultaneous bilateral compared with unilateral percutaneous nephrolithotomy.
OBJECTIVE
To compare simultaneous bilateral percutaneous nephrolithotomy (SBPCNL) and unilateral PCNL in separate sessions in patients with bilateral renal stones for several variables before and after surgery.


METHODS
The results from SBPCNL carried out at two centres in different countries on 198 patients (aged 1.25-70 years) were compared with those from 300 patients undergoing unilateral PCNL in separate sessions. At one centre where extracorporeal shockwave lithotripsy (ESWL) was available SBPCNL was used for stones where at least two sessions of ESWL would have been required on each side. Other associated procedures were also used wherever required.


RESULTS
The stones were cleared bilaterally in one session of SBPCNL in 190 patients; in eight, fragments of < 3 mm remained but were not clinically significant. A second session was required in six patients on one side only. Variables assessed before and after treatment (e.g. hospital stay, analgesia requirements and complications) were not significantly different between SBPCNL and PCNL. The mean (range) total operative duration for SBPCNL was 46 (20-100) min and the hospital stay 4.3 (3-8) days.


CONCLUSIONS
From this experience, SBPCNL is a cost-effective and beneficial solution for selected patients, with clear advantages over separate unilateral PCNL in patients with bilateral stones.
Holman
E
E
Department of Urology, Semmelweis Hospital, Kiskunhalas, Hungary.
Khan
A Munim
AM
Pásztor
I
I
Tóth
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D002129:Calcium Oxalate / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007669:Kidney Calculi / Q000737:chemistry / Q000208:ethnology / Q000628:therapy*; D007902:Length of Stay; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D010154:Pakistan / Q000208:ethnology; D012086:Reoperation; D014527:Uric Acid / Q000032:analysis; D015006:Yemen / Q000208:ethnology
D002129:Calcium Oxalate; D014527:Uric Acid