Efficacy of PCNL in the resolution of symptoms of nephrolithiasis

Abstract

Patients undergo Percutaneous Nephrolithotomy (PCNL) for the resolution of pain, but at times, other symptoms such as hematuria, dysuria, nausea, emotional distress, and anxiety are also the presenting symptoms. While pain resolution after successful surgery is generally the focus, the resolution rate of other symptoms after surgery is not described. Our study aims to determine the efficacy of PCNL for the resolution of other symptoms. Patients aged > 18 years who underwent PCNL from September 2019 to 2021 were interviewed face-to-face and asked questions regarding their symptoms before and 3 months after the surgery. Their response was noted on an 11-point Numerical-Rating-Scale (NRS) of 0–10. The primary outcome was symptom resolution rate at 3 months after PCNL. The secondary outcomes were rate of resolution of gross hematuria, dysuria, anorexia and nausea, emotional distress and anxiety, work interference, and daily routine activities. Only patients who had complete stone clearance in a single sitting were included. Of the total 110 patients, almost half (45.45%) of the patients reported having one or more symptoms at or after 3 months of surgery. The reduction in proportion of patients and mean difference in preoperative and postoperative NRS scores of symptoms were statistically significant. Symptoms that persisted were mild and posed slight discomfort to the patient. Complete resolution of all the symptoms may not be achieved even in patients who have complete clearance after PCNL, and a few symptoms can persist, however, only mild. Appropriate preoperative counselling of the patients is, therefore, essential.