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Worldwide practice patterns of percutaneous nephrolithotomy

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Abstract

Purpose

To evaluate the current practice of percutaneous nephrolithotomy (PCNL), conducting a worldwide survey among urologists with a special interest in endo-urology.

Methods

A 22-question survey was specifically developed by the European Association of Urology (EAU) young academic urologists (YAU) and uro-technology (ESUT) groups and globally distributed via SurveyMonkey to almost 2000 members of Endourology Society. The questionnaire included questions dedicated to the demographics and general practice of the participating urologists.

Results

In total, 441 responses (male/female ratio – 418/23) were received. A comparatively higher percentage of specialists (56.2%) practiced in academic institutions and had specific endo-urological fellowship training (56.7%). The classical prone PCNL remained the most practiced approach among the surveyed specialists, 47.7% stated to always do prone PCNLs, while 51.8% of respondents used multiple positioning options as required. The PCNL tract was mostly performed by urologists (84.3%) and fluoroscopic guidance was still predominantly used by 74.5% of respondents. The most practiced tract dilation method was balloon dilator used by 42% of respondents. Most of the surveyed urologists had ultrasonic, pneumatic or laser lithotripsy devices in their armamentarium. The use of some form of post-procedural drainage was reported in 85.1% of respondents, whereas tubeless PCNL remained a fairly uncommon practice.

Conclusion

The majority of urologists still use prone positioning, get their own access under fluoroscopy guidance and use a balloon for tract dilation. However, we also identified that when necessary, urologists will deviate from routine practice and change strategy, adopting other approaches for PCNL.

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Author information

Author notes

  1. Thomas Tailly and Arman Tsaturyan have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, University Hospital of Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium

    Thomas Tailly

  2. EAU Young Academic Urologists (YAU) Urolithiasis and Endourology Working Group, Arnhem, The Netherlands

    Thomas Tailly, Esteban Emiliani, Amelia Pietropaolo, Mehmet Ozsoy, Emre Tarik Sener, Michele Talso, Senol Tonyali & Panagiotis Kallidonis

  3. EAU Section of Uro-Technology (ESUT), Arnhem, The Netherlands

    Thomas Tailly, Esteban Emiliani, Bhaskar Somani & Panagiotis Kallidonis

  4. Department of Urology, University of Patras, Patras, Greece

    Arman Tsaturyan & Panagiotis Kallidonis

  5. Department of Urology, Fundacio Puigvert, Autonomous University of Barcelona, Barcelona, Spain

    Esteban Emiliani

  6. Department of Urology, University Hospital of Southampton, NHS Trust, Southampton, UK

    Bhaskar Somani & Amelia Pietropaolo

  7. Department of Urology, Medical University of Vienna, Vienna, Austria

    Mehmet Ozsoy

  8. Department of Urology, Marmara University School of Medicine, Istanbul, Turkey

    Emre Tarik Sener

  9. Department of Urology, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy

    Michele Talso

  10. Department of Urology, University of Istanbul, Istanbul, Turkey

    Senol Tonyali

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  1. Thomas Tailly
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  2. Arman Tsaturyan
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Contributions

TT – Protocol/project development, data collection, data analysis and manuscript writing. A – Data collection, data analysis and manuscript writing. EE – Data collection and manuscript writing. BS – Data collection and manuscript writing. AP – Data collection and manuscript writing. MO – Data collection and manuscript writing. ETS – Data collection and manuscript writing. MT – Data collection and manuscript writing. ST – Data collection and manuscript writing. PK – Protocol/project development, data collection, data analysis and manuscript writing.

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Correspondence to Thomas Tailly.

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Tailly, T., Tsaturyan, A., Emiliani, E. et al. Worldwide practice patterns of percutaneous nephrolithotomy. World J Urol 40, 2091–2098 (2022). https://doi.org/10.1007/s00345-022-04067-3

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  • DOI: https://doi.org/10.1007/s00345-022-04067-3

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