Ultrasound versus Fluoroscopy Guided Percutaneous Nephrolithotomy for Treatment of Calculi in Hydronephrotic Kidneys

Purpose: To compare the success and complication rates of ultrasound with fluoroscopically guided Percutaneous Nephrolithotomy (PCNL) in hydronephrotic kidneys. Patients and Methods: The computer archived files of patients with renal calculi who underwent PCNL between October 2007 and November 2012 were retrospectively reviewed. The study included adult patients with hydronephrotic kidneys. Based on surgeon preference, included patients were divided into 2 groups. Ultrasound (U.S) guided group comprised patients who underwent ultrasound guided PCNL and fluoroscopy-guided group that included patients who underwent fluoroscopy guided PCNL. Preoperative, operative, postoperative data and outcomes (success and complication rates) were compared Results: The study included 91 patients (mean age 44.4±11). US-guided PCNL was used in 42 patients (35 males and 7 females, mean age 40.2±13 years), and fluoroscopy in 49 patients (39 males and 10 females, mean age 43 ±21years).Mean operative time was 105 ±7.9 minutes (US-guided) versus 130±11.6 (fluoroscopy-guided) (P = 0.0001). Successful puncture was achieved in (38 patients) 90.5% in group-1 and 46 patients 93.9% in group-2 (P=0.69). Success of renal puncture in moderate/severe hydronephrotic kidneys was 96.4% versus 100%, and in mild hydronephrosis 78.6% versus 92.1% in US and fluoroscopy groups, respectively. Postoperatively, the complication rate was 9.5% in group-1, and 8.2% in group-2. Mean hospital stay was similar in both groups (3±1.5 days). The success rates were 90.5% in group1 and 93.9% in group 2, respectively. Conclusion: In hydronephrotic kidneys, Ultrasound-guided PCNL is comparable with fluoroscopy-guided PCNL.