Comparison of Mean Hospital Stay in Patients Undergoing Tubed Versus Tubeless Percutaneous Nephrolithotomy: A Randomized Controlled Trial

Background: Percutaneous nephrolithotomy (PCNL) is the standard surgical intervention for managing large or complex renal calculi. Traditionally, the procedure concludes with the placement of a nephrostomy tube (tubed PCNL), intended to ensure drainage, hemostasis, and access for secondary procedures. However, growing interest in tubeless PCNL—where the nephrostomy tube is omitted—has prompted evaluation of its safety, efficacy, and impact on postoperative recovery, particularly hospital stay duration. Objective: To compare the mean hospital, stay in patients undergoing tubed versus tubeless percutaneous nephrolithotomy (PCNL) for renal calculi. Methods: This randomized controlled trial was conducted at Bolan Medical College and Hospital, Quetta, from January 2025 to May 2025. Sixty patients were randomized into two equal groups: one undergoing standard PCNL with nephrostomy tube placement and the other undergoing tubeless PCNL. Data on demographic, clinical, and perioperative characteristics were collected. The primary outcome was mean hospital stay. Results: The tubeless PCNL group demonstrated a significantly shorter hospital stay compared to the tubed group (mean ± SD: 3.1 ± 1.1 vs. 4.5 ± 2.1 days; p < 0.05). Conclusion: Tubeless PCNL offers a shorter hospital stay compared to traditional tubed PCNL without compromising patient safety.