Worldwide practice patterns of percutaneous nephrolithotomy


Tailly T., Tsaturyan A., Emiliani E., Somani B., Pietropaolo A., Ozsoy M., ...More

WORLD JOURNAL OF UROLOGY, vol.40, pp.2091-2098, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 40
  • Publication Date: 2022
  • Doi Number: 10.1007/s00345-022-04067-3
  • Journal Name: WORLD JOURNAL OF UROLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, EMBASE, Gender Studies Database, MEDLINE
  • Page Numbers: pp.2091-2098
  • Keywords: Percutaneous nephrolithotomy, Survey, Patient position, PCNL puncture, Tract dilation, TRACT DILATION METHODS, EAU GUIDELINES, MANAGEMENT
  • Istanbul University Affiliated: Yes

Abstract

Purpose To evaluate the current practice of percutaneous nephrolithotomy (PCNL), conducting a worldwide survey among urologists with a special interest in endo-urology. Methods A 22-question survey was specifically developed by the European Association of Urology (EAU) young academic urologists (YAU) and uro-technology (ESUT) groups and globally distributed via SurveyMonkey to almost 2000 members of Endourology Society. The questionnaire included questions dedicated to the demographics and general practice of the participating urologists. Results In total, 441 responses (male/female ratio - 418/23) were received. A comparatively higher percentage of specialists (56.2%) practiced in academic institutions and had specific endo-urological fellowship training (56.7%). The classical prone PCNL remained the most practiced approach among the surveyed specialists, 47.7% stated to always do prone PCNLs, while 51.8% of respondents used multiple positioning options as required. The PCNL tract was mostly performed by urologists (84.3%) and fluoroscopic guidance was still predominantly used by 74.5% of respondents. The most practiced tract dilation method was balloon dilator used by 42% of respondents. Most of the surveyed urologists had ultrasonic, pneumatic or laser lithotripsy devices in their armamentarium. The use of some form of post-procedural drainage was reported in 85.1% of respondents, whereas tubeless PCNL remained a fairly uncommon practice. Conclusion The majority of urologists still use prone positioning, get their own access under fluoroscopy guidance and use a balloon for tract dilation. However, we also identified that when necessary, urologists will deviate from routine practice and change strategy, adopting other approaches for PCNL.