The role of stone composition in determining outcomes after percutaneous nephrolithotomy.

Abstract

Objective: To investigate the impact of stone composition on peroperative and postoperative outcomes in patients undergoing percutaneous nephrolithotomy (PCNL).

Methods: We retrospectively analyzed data from 152 patients who underwent PCNL at our institution between January 2020 and August 2024. Patients were divided into subgroups based on stone composition: calcium oxalate, calcium phosphate, uric acid, cystine, and struvite. We compared peroperative and postoperative outcomes, including stone-free rates, complications, and the need for auxiliary procedures, between the groups.

Results: The overall stone-free rate was 63.8%. When complications were grouped as minor and major according to Clavien, no statistically significant difference was found between the groups in terms of patient characteristics, stone characteristics and perioperative techniques. When patient characteristics, stone characteristics and perioperative data were compared between stone compositions, statistically significant differences were found between the groups in terms of age, gender, comorbidity, The American Society of Anesthesiologists (ASA) score, stone size and stone density. Stone-free rates varied significantly based on stone composition (p = 0.024). There was a statistically significant association between stone composition and postoperative sepsis (p < 0.001).

Conclusion: Stone composition can significantly impact stone-free rates and postoperative complications in patients undergoing PCNL. These results underscore the importance of considering stone composition when planning PCNL and tailoring treatment strategies.