Renal drainage after percutaneous nephrolithotomy

Arun K. Srinivasan, Amin Herati, Zeph Okeke, Arthur D. Smith

Research output: Contribution to journalReview article

Abstract

Exit strategy after percutaneous nephrolithotomy (PCNL) is an area of continuing innovation to improve postoperative morbidity and operative outcomes for patients. The two important components of an exit strategy after PCNL are hemostasis and renal drainage. We review the different techniques of renal drainage after PCNL-ie, nephrostomy tube, ureteral stents, and totally tubeless strategy with critical discussion of available evidence for and against each of these techniques. We conclude that the optimal renal drainage method depends on patient characteristics and the operative course; hence, it should be individualized. To simplify this, we group patients undergoing PCNL as routine, problematic, and complicated, based on increasing complexity of the procedure and procedural complications. In routine PCNLs, we favor placement of an ureteral stent or a small-bore nephrostomy tube. In problematic and complicated PCNLs, we think the evidence directs toward placement of a nephrostomy tube, small bore being an option in problematic PCNLs.

Original languageEnglish (US)
Pages (from-to)1743-1749
Number of pages7
JournalJournal of Endourology
Volume23
Issue number10
DOIs
StatePublished - Jan 10 2009
Externally publishedYes

ASJC Scopus subject areas

  • Urology

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