Comparison of Postoperative Outcomes in Standard Versus Tubeless Percutaneous Nephrolithotomy

Objective: To compare the outcomes of tubeless percutaneous nephrolithotomy (PCNL) over standard PCNL in terms of postoperative pain and rescue analgesia needed. Study type, settings & duration: This comparative randomized controlled study was done at Department of Urology, Pakistan Institute of Medical Sciences, Islamabad from September 2022 to February 2023. Methodology: Total 112 adult patients of either gender between age 18-65 years were enrolled. The patients had radiographic findings of ≥ 1cm kidney stones. Enrolled patients were allocated randomly into two treatment groups. Patients of Group-A underwent tubeless PCNL procedure in which nephrostomy tube was not inserted and a double J (DJ) stent was placed. Patients of Group-B underwent PCNL with placement of nephrostomy tube for drainage and DJ stent was not inserted. Postoperative pain was assessed in both groups. The hospital stay mean was also estimated in the groups. Results: Patients mean age was 35.3±12.7 years. Stone size mean in group-A was 1.82±0.61 cm and in group-B was 2.15±0.64 cm. Mean VAS score was estimated at different time intervals. At 24 hours after the surgery, mean VAS was 2.09±1.24 in group-A and it was 3.69±1.41 in group-B (p =0.001). In group-A, mean number of rescue injections used in 24 hours after surgery was 2.18±1.18 and in group-B it was 3.51±0.66 (p =0.001). The hospital stay mean was also estimated in both groups. In group-A, mean was 1.44±0.51 days and in group-B it was 2.86±0.75 (p =0.001).