title: Prospective randomized comparison of retroperitoneoscopic pyelolithotomy versus percutaneous nephrolithotomy for solitary large pelvic kidney stones.
abstract: OBJECTIVE
  We performed a prospective randomized comparison of retroperitoneoscopic pyelolithotomy (RP) versus percutaneous nephrolithotomy (PNL) for solitary pelvic stones >3 cm and assessed the outcome results.
  
  
  METHODS
  From 2010 to 2012, 44 patients with a solitary pelvic stone >3 cm without any anatomical abnormality were randomized to either RP or PNL on a 1:1 ratio. Stone-free rate, number of procedures per patient and complications were recorded.
  
  
  RESULTS
  The stone-free rate on the first postoperative day was 95.5% in the RP group versus 72.7% in the PNL group (p = 0.04). The stone-free rates at 3 months were similar between the two groups. Blood loss, visual pain analog score and analgesic requirement on the first postoperative day were significantly higher in the PNL group whereas the mean operative time and overall complications were similar between the two groups.
  
  
  CONCLUSIONS
  In patients with solitary large pelvic stones, RP is associated with lesser blood loss, postoperative pain and analgesia as well as with a higher stone-free rate in the immediate postoperative period in comparison to PNL. However, the stone clearance rate remains the same at 3 months in both groups.
authors.affiliation: Department of Urology, King George Medical University, Lucknow, India.
authors.forename: Vishwajeet
authors.initials: V
authors.lastname: Singh
authors.forename: Rahul Janak
authors.initials: RJ
authors.lastname: Sinha
authors.forename: Dheeraj Kumar
authors.initials: DK
authors.lastname: Gupta
authors.forename: Mohit
authors.initials: M
authors.lastname: Pandey
mesh_terms: D000328:Adult; D000698:Analgesia; D000700:Analgesics / Q000627:therapeutic use; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D061646:Operative Time; D010149:Postoperative Pain; D011184:Postoperative Period; D011446:Prospective Studies; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
chemical_list: D000700:Analgesics