Superiority of percutanous nephrolithotomy over extra corporeal shockwave lithotripsy in renal stones management : King Hussein medical center experience

Abstract EN

Objectives: To compare between percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL) in renal stone management and persistent bacteria clearance rate after the complete extraction of these stones.

Methods: The medical files of (340) patients who underwent PCNL or ESWL for kidney stone between February 2016 and July 2017 were reviewed retrospectively, Patients with positive urine culture, stone size at 10-45mm, age 23-66 year of both genders, and a normal creatinine were included.

Patient with uncontrolled hypertension, pregnant ladies, patients with ureteric obstruction or suspicious renal mass, age younger than 23 years, patients with single or transplanted kidney were excluded.

In all, 340 patients were included with a mean (SD, range) age of 40.08 (±10.087, 23-66) years, and followed up from the first day post each procedure till (3 – 8 months).

The clearance rate of stone and bacteria, stone size, fever post procedure, duration of antibiotics administration, type of hydronephrosis were compared between both groups.

Results: 178 patients were treated by PCNL and 162 by ESWL.

The stone bacteria clearance rate and residual stone and persistent bacteriuria rate for PCNL were (80.3% vs.19.6%, respectively, P=0.009), while for ESWL were (53% vs.47%, respectively, p=0.152), so the result showed that the clearance rate of stone and bacteriuria was significantly higher within the PCNL group Conclusion: PCNL is superior to ESWL regarding stone and bacteria clearance rate.