Re: Antibiotic resistance and trend of urinary pathogens in general outpatients from a major urban city.

collecting system. Early in one’s experience, a catheterized approach may be beneficial for maximizing successful access with minimal complications. Once a level of comfort with percutaneous anatomy is achieved, a noncatheterized approach may be a natural evolution to performing percutaneous nephrolithotomy. A larger randomized study would assist in determining the value of pre-procedure catheter placement for obtaining optimal access to the collecting system. As there are a limited number of published randomized studies on access relating to percutaneous nephrolithotomy, the authors should be congratulated on their contribution.”