Residual Stones after Percutaneous Nephrolithotomy

Current EAU guide recommend the PCNL as the gold standard procedure for stones larger than 2 cm and stones larger than 1 cm if in the lower calyx in patients with unfavorable factors for SWL. Residual fragments are commonly seen after both, ESWL and after intracorporeal lithotripsy. The incidence of residual stones after PCNL ranges from 10% to 60%. But some of these studies with high success rate established the clinically insignificant residual fragments (CIRF) as being stone free. The ability to detect residual fragments is dependent on the imaging modality and this gives different outcomes when different modalities used to assess the stone free rate. Residual stones worth to be more studied because it gives rise to two major problems namely regrowth and recurrent urinary tract infection. The residual stones may pass spontaneously; remain silent with no growth, become symptomatic with pain, heamaturia, infection and obstruction or act as a nidus and increase in size. Although routine imaging follow up is mandatory and is recommended by the EAU there are no current scheduled programs for follow up. In this mini review we tried to address the residual stones after PCNL in the literature regarding definition, incidence, diagnosis, fate and the possible methods of management. *Corresponding author: Mohamed F Abdelhafez, Urologist, Department of Urology, University Hospital Tübingen, Eberhard-Karls University, Tübingen, Germany, E-mail: [email protected] Received June 29, 2013; Accepted September 16, 2013; Published September 20, 2013 Citation: Abdelhafez M F (2013) Residual Stones after Percutaneous Nephrolithotomy. Med Surg Urol 2: 115. doi:10.4172/2168-9857.1000115 Copyright: © 2013 Abdelhafez M F. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.