Comparative study of the outcome of tubed versus tubeless percutaneous nephrolithotomy

Percutaneous nephrolithotom (PCNL) is the best choice in treating renal stones currently. The PCNL is followed by placement of nephrostomy tube and stent that help in tamponade of percutaneous tract. Tubeless PCNL is accompanied by less postoperative pain and shorter hospital stay. Despite advantages of tubeless PCNL, some surgeonsstill excluded bleeding or residual stone patients, no chance of second look which increase chance of missing residual stone fragments, requiring often an additional procedures like cystoscopy, stent dysuria and risk of no drainage for kidney. This study aimed to compare the effectiveness and safety of tubeless PCNL to tubed PCNL. Methods: A prospective comparative study conducted in Urology department of Safeer Al-Imam Al-Hussein in Karbala, from January 2013, 1stto December, 31th 2017. One thousand four hundreds thirty four patients with renal stones surgically operated with PCNL were categorized into two groups; 882 patients with renal stones were treated with tubed PCNL and 552 patients were treated with tubeless PCNL. Results: The young age female were predominantly related to tubeless PCNL. Left sided stones with lucent and upper approach were significantly associated with tubeless PCNL. The tubed PCNL was significantly related to right side stone, while tubeless PCNL was significantly related to left side stone (p = 0.006). Tubeless PCNL was significantly associated with lucent opacity more than tubed PCNL (p = 0.001). Postoperatively, tubeless PCNL was significantly associated with lower rates of residual stone (p = 0.005), bleeding (p = 0.04) and sepsis (p = 0.01) compared to tubed PCNL. Conclusion: The tubeless option is effective and safe modality for PCNL.The low rate of residual stones and postoperative bleeding and sepsis can safely have associated with Tubeless PCNL.