Nadeem Iqbal*, Sajid Iqbal, Aisha Hasan, Aimen Iqbal, Keron A.A. Blair, Dan M.J. Milstein, Saeed Akhter

Iqbal et al. J Clin Transl Res 2022; 8(2):8

Published online: March 19, 2022


Background: Percutaneous nephrolithotomy (PCNL) has evolved as a standard procedure to treat large-sized renal stones. A nephrostomy tube is used frequently in this procedure, however, data regarding tubeless PCNL procedures in elder patients is scarce. Aim: The aim of this study was to review the results and outcomes associated with tubeless PCNL procedures in the elderly population.
Methods: A retrospective review of patients aged ≥60 years at our hospital that were treated for renal stones by percutaneous nephrolithotomy procedure. The patients were separated into 2 groups: group 1 underwent tubed PCNL procedures and group 2 received tubeless PCNL procedures. Information regarding variables were recorded in specified proforma and then processed in SPSS statistics analyses. Statistical tests were utilized for continuous and categorical variables and a p-value of <0.05 was considered statistically significant.
Results: 121 patients with a mean age of 65±5 years were included in the analysis. Mean stone size and BMI were 3.4±1.5 cm and 26.2±4.3 kg/m2 respectively. Mean operative time was longer in tubed PCNL as compared to the tubeless group. Mean hospital stay was similar among the tubed and tubeless PCNL treated groups. Mean analgesic doses were significantly lower in the tubeless group. The overall stone-free rate was 89/121 patients (74%).
Conclusion: Tubeless PCNL can be safely undertaken in geriatric patients and has potential advantages associated with shorter operative times and reduced necessity for analgesia.
Relevance for patients: Tubeless PCNL is considered advantageous as it can reduce postoperative pain and analgesia necessity, shorten hospitalization and lower cost in young patients. However, there is no clear evidence with reference to virtue of tubeless PCNL in the elderly age groups. This study will analyze and review results and outcomes associated with tubeless PCNL in a cohort of elderly patients.


Author affiliation

1. Dept. of Urology and Kidney Transplant, Shifa International Hospital, Islamabad, Pakistan
2. Dept. of Rehabilitation, Pakistan Navy PNS Hospital, Karachi, Pakistan
3. Riphah International University, Rawalpindi, Pakistan
4. Bahria University Medical and Dental College, Karachi, Pakistan
5. American International School of Medicine, Georgetown, Guyana
6. Dept. of Oral & Maxillofacial Surgery, Amsterdam University Medical Centre, Location: AMC, Amsterdam, The Netherlands

* Corresponding author:
Nadeem Iqbal
Dept. of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital Ltd. Pitras, Bukhari Road, Sector H-8/4, Islamabad, Pakistan
Tel: 0334-5346538

Handling editor:
Michal Heger
Department of Pharmaceutics, Utrecht University, the Netherlands
Department of Pharmaceutics, Jiaxing University Medical College, Zhejiang, China


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