, Volume 46, Issue 2, pp 219–219 | Cite as

How can the operation time be shortened by reducing the tract size?

  • Kadir Yildirim
  • Namik Kemal Hatipoglu
Letter to the Editor

Dear Editor,

We read the article by Karakan et al. with great interest [3]. It is a valuable randomized prospective study in the literature that compares the ultramini percutaneous nephrolithotomy (UMP) with the standard percutaneous nephrolithotomy (SPNL). The authors conclude that UMP had low complication rate and high success rate; moreover, they indicated that UMP’s operation time was significantly shorter than SPNL [3].

As the size of tract increases, the likelihood of renal damage and bleeding increases too. Bleeding is one of the most disturbing complications of PNL. Theoretically, a smaller tract causes less complication. Previous studies reported that reducing tract size could also reduce bleeding and thus reduce complications without affecting success rate [1].

UMP has both advantages and disadvantages. The main advantage of UMP is the lower complication rate due to small tract size. On the other hand, stone fragments to be extracted associated with the tract size will be smaller and the operation will be time consuming. This is supported by the literature so far [2]. It is observed that authors did not consider this fact in their study.

Consequently, we wonder the answer of the question ‘How can the operation time be shortened by reducing the tract size?’.


Compliance with ethical standards


There are no funding.

Conflict of interest

Author Kadir Yildirim declares that he has no conflict of interest. Author Namik Kemal Hatipoglu declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Dede O, Sancaktutar AA, Dagguli M, Utangac M, Bas O, Penbegul N (2015) Ultra-mini-percutaneous nephrolithotomy in pediatric nephrolithiasis: both low pressure and high efficiency. J Pediatr Urol 11:253.e251–256CrossRefGoogle Scholar
  2. 2.
    Desai J, Zeng G, Zhao Z, Zhong W, Chen W, Wu W (2013) A novel technique of ultra-mini-percutaneous nephrolithotomy: introduction and an initial experience for treatment of upper urinary calculi less than 2 cm. Biomed Res Int 2013:490793CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Karakan T, Kilinc MF, Doluoglu OG, Yildiz Y, Yuceturk CN, Bagcioglu M, Karagoz MA, Bas O, Resorlu B (2017) The modified ultra-mini percutaneous nephrolithotomy technique and comparison with standard nephrolithotomy: a randomized prospective study. Urolithiasis 45:209–213CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of UrologyElazig Training and Research HospitalElazigTurkey
  2. 2.Department of UrologyUniversity of DicleDiyarbakirTurkey

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