Effects of Percutaneous Nephrolithotomy on Renal Morphology and Arterial Vascular Resistance

Introduction Urolithiasis is the most common disorders seen in urology clinics around the globe, leading surgeons to adopt percutaneous nephrolithotomy (PCNL) as the standard approach for treating large stones. However, data about how this procedure alters kidney structure and blood flow, particularly arterial resistance, remain surprisingly scarce. The present study therefore set out to measure the effects of PCNL on renal anatomy and vascular resistance by means of grey scale and color Doppler ultrasound. Methodology At Mahatma Gandhi Medical College and Research Institute, Puducherry, a cross-sectional study was conducted from October 2022 to April 2024. Forty patients who had PCNL for large stones agreed to participate in the study with 12-18-month postoperative assessment. Trained radiologists recorded resistive index (RI), parenchymal thickness, and echogenicity with color Doppler imaging. Results were analysed with standard statistical tests, considering p-values smaller than 0.05 as significant. Results The sample contained 40 patients whose average age was 43.8 ± 12.7 years; male subjects made up 72.5% (n = 29) and female subjects 27.5% (n = 11) of the cohort. The renal RI measured in the treated kidney averaged 0.624 ± 0.040, while the corresponding value for the contralateral kidney was 0.611 ± 0.037. Normal echogenicity was noted in 97.5% (n = 39) of patients, with only 2.5% (n = 1) displaying hyperechogenic areas. Serum creatinine levels averaged 1.14 ± 0.42 mg/dL, underscoring overall preserved renal function. No statistically significant differences emerged between the operated and contralateral kidneys in vascular resistance. Conclusion Taken together, these data suggest that PCNL exerts trivial effects on renal structure and arterial resistance during a 12-18-month follow-up period. The procedure can therefore be regarded as safe, having maintained both renal function and morphology throughout a follow-up period of 12 to 18 months.