title: Balloon dilator versus telescopic metal dilators for tract dilatation during percutaneous nephrolithotomy for staghorn stones and calyceal stones.
abstract: OBJECTIVE
  To compare the results of balloon dilatation (BD) vs. telescopic metal dilators (TMDs) in establishing the tract for percutaneous nephrolithotomy (PCNL) in patients with calyceal stones or staghorn stones, but with no hydronephrosis.
  
  
  METHODS
  Data from selected patients over 4 years were recorded retrospectively. Patients with complex staghorn stones, an undilated targeted calyx, or the stone filling the targeted calyx, were included in the study. In all, 97 patients were included, of 235 undergoing PCNL between March 2010 and March 2014, and were divided into two groups according to the technique of primary tract dilatation. Group A included patients who had BD and group B those treated using TMDs.
  
  
  RESULTS
  In group A (BD, 55 patients) dilatation was successful in 34 (62%). The dilatation failed or there was a need for re-dilatation using TMD in 21 patients (38%). In one of these 21 patients the dilatation failed due to extravasation. In group B (TMD, 42 patients) dilatation was successful in 38 (90%) patients, with incomplete dilatation and a need for re-dilatation in four (10%) patients, and no failed procedures. Group A had a significantly higher failure rate than group B (P < 0.001). Differences in operative duration, blood loss, stone-removal success rate and complication rate were statistically insignificant.
  
  
  CONCLUSIONS
  BD has a higher failure rate than TMD when establishing access for calyceal stones or staghorn stones that have little space around them.
authors.affiliation: Urology Department, Faculty of Medicine, Menoufiya University, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Shazly
authors.affiliation: Urology Department, Faculty of Medicine, Menoufiya University, Egypt.
authors.forename: Shady
authors.initials: S
authors.lastname: Salem
authors.affiliation: Urology Department, Farwaniya Hospital, Kuwait.
authors.forename: Adel
authors.initials: A
authors.lastname: Allam
authors.affiliation: Urology Department, Farwaniya Hospital, Kuwait.
authors.forename: Badawy
authors.initials: B
authors.lastname: Hathout
keywords: BD, balloon dilator (dilatation); Dilators; Nephrolithotomy; PCNL, percutaneous nephrolithotomy; Percutaneous; Stones; TMD, telescopic metal dilator (dilatation)