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Which position is more advantageous for percutaneous nephrolithotomy: supine or prone?

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Abstract

Percutaneous nephrolithotomy (PNL) can be performed in a number of different positions. Our aim was to evaluate the convenience and advantages of the supine position following the transition from the prone to the supine position. 94 patients undergoing supine PNL (Group-1) and 93 patients undergoing prone PNL (Group-2) were retrospectively reviewed and included in the study. Patients who underwent mini-PNL (mPNL) were selected from Group-1 and Group-2 and divided into Group-1A supine mPNL patients (77) and Group-2A prone mPNL patients (53). Demographic characteristics, operative data and post-operative parameters were compared between these groups. The operation time was 74.4 ± 21.9 min in Group-1A and 79.2 ± 19.8 min in Group-2A (p = 0.076). The median value of fluoroscopy time was 30 s in Group-1A and 40 s in Group-2A (p = 0.003). In Group-1A, 59 patients had no intraoperative double-J stent (DJS) insertion and 18 patients had DJS insertion, while in Group-2A, 24 patients had no DJS insertion and 29 patients had DJS insertion (p < 0.001). MPNL was performed in 81.9% of patients in the supine position and 57% in the prone position. This difference was statistically significant (p < 0.001). No significant difference was found with regard to the success rate and the complications of mPNL. Fluoroscopy time is shorter in the supine position. Moreover, the insertion rates of DJS are low. With increasing experience, we have found that our standard PNL (sPNL) rate is gradually decreasing and more mPNL is being performed.

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Funding

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Authors and Affiliations

  1. Department of Urology, Necip Fazil City Hospital, Kahramanmaraş, Turkey

    Mustafa Kucukyangoz

  2. Department of Urology, Private Acıbadem Hospital, Eskişehir, Turkey

    Adnan Gucuk

Authors
  1. Mustafa Kucukyangoz
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  2. Adnan Gucuk
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Contributions

MK: Project development, data collection, manuscript writing, and editing AG: Project development and manuscript editing.

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Correspondence to Mustafa Kucukyangoz.

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This study was performed in accordance with the ethical standards of the Declaration of Helsinki.

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Kucukyangoz, M., Gucuk, A. Which position is more advantageous for percutaneous nephrolithotomy: supine or prone?. Urolithiasis 51, 102 (2023). https://doi.org/10.1007/s00240-023-01474-y

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