title: Can we reduce secondary surgical interventions and length of hospitalization in percutaneous nephrolithotomy?
abstract: OBJECTIVE
  To evaluate the success and complication rates of percutaneous nephrolithotomy (PNL) operations and to determine the effect of postoperative late removal of an open-end ureter catheter on hospital stay and on secondary interventions.
  
  
  METHODS
  The records of 198 patients (97 female, 101 male) who had PNL between May 2009 and February 2012 were retrospectively reviewed. The open-end ureter catheter which was placed during the operation was removed at the end of the operation in the first 53 patients ( group 1) and 12 hours after the nephrostomy catheter in 145 patients ( group 2).
  
  
  RESULTS
  PNL intervention was performed in 198 patients with a mean age of 40.83 ± 13.64 years and mean stone load of 9.82 ± 5.37cm2 (range 2 to 26 cm2). When clinically insignificant stone pieces < 4 mm were accepted as successful, the total success rate was 80.80 % (79.2% in group1 and 81.4% in group 2, P = .50). The hospitalization period was significantly reduced in group 2 (3.45 ± 0.95 days vs. 2.61 ± 0.65 days; P = .006). While secondary surgical intervention was not necessary in any of the patients in group 2 (0.0%), but 4 patients (7.5%) required ureterorenoscopy plus double-J stent placement following the primary procedure in group 1 (P = .006).
  
  
  CONCLUSIONS
  PNL is a safe procedure with a high success rate and a short hospitalization period. There was a significant decrease in the hospitalization period and secondary surgical intervention rates with the postoperative late removal of the open-end ureter catheter.
authors.affiliation: Department of Urology, Muğla University, Medical Faculty,Muğla,Turkey. hasandeliktas@mu.edu.tr.
authors.forename: Hasan
authors.initials: H
authors.lastname: Deliktaş
authors.affiliation: Department of Urology, Şehitkamil State Hospital, Gaziantep, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Yapici
authors.affiliation: Department of Urology, Şehitkamil State Hospital, Gaziantep, Turkey.
authors.forename: Utku
authors.initials: U
authors.lastname: Ozen
authors.affiliation: Department of Urology, Şehitkamil State Hospital, Gaziantep, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Yalçin
authors.affiliation: Department of Urology, Muğla University, Medical Faculty, Muğla, Turkey.
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Sahin
mesh_terms: D000328:Adult; D020878:Device Removal; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D011182:Postoperative Care; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014513:Ureter; D018666:Ureteroscopy; D062885:Urinary Catheters