Simultaneous bilateral percutaneous nephrolithotomy: a single-center experience.

Purpose: To evaluate the safety and efficacy of simultaneous bilateral percutaneous nephrolithotomy (SBPCNL) for bilateral renal calculus disease.

Patients And Methods: A retrospective study was conducted from June 1996 to February 2006 involving 38 male and 7 female patients with a mean age of 44 years (range 5-73 years) with 90 affected renal units who underwent SBPCNL under general anesthesia. Those patients with established nephrostomy tracts were excluded from the study group.

Results: The average duration of the procedure was 107 +/- 43 minutes (range 60-220 minutes). The average drop in hemoglobin was 2 +/- 1.2 g/dL (range 0.3-5.6 g/dL), with 3 patients (7%) requiring blood transfusion. In 87% of patients, a single stage was performed on both sides, while 13% required two stages on one side. A single tract was on both sides utilized in 78%, while 22% of the patients required two tracts on one side. None required two tracts on both sides or more than one stage on both sides. The stone-clearance rate was 96%. The average hospital stay was 6 days. Complications consisted of renal-pelvic perforation in two patients and transient pyrexia in five. Three patients had persistent urine leak on one side, of which two stopped spontaneously and one necessitated ureteral stenting.

Conclusion: Simultaneous bilateral PCNL is a safe procedure and can be used effectively in adults as well as in children. In addition to being cost effective, it involves only a single anesthesia with a shorter hospital stay and faster convalescence. However, patients with a large stone burden or complex pelvicaliceal anatomy should not be selected for SBPCNL.