Background Percutaneous nephrolithotomy (PCNL) is the best option for the treatment of renal calculi greater than 2 cm in diameter according to recent guidelines. To avoid increased intrarenal pressure and postoperative fever following this procedure with the upper pole hydronephrosis antegrade irrigation through a separate access in the upper pole through a nephrostomy tube has been conducted in the present study to overcome such complications. Objective Assess using of this new technique in lessening the intrarenal pressure and postoperative fever following miniaturized percutaneous nephrolithotomy (mini-PCNL). Patient and methods This prospective nonrandomized clinical study was conducted on patients with a unilateral renal stone size of 20–30 mm without contraindications to mini-PCNL. The preoperative characteristics including age, sex, BMI, stone location, and stone burden were analyzed. The primary end point is to evaluate postoperative fever. The secondary end point is to assess the stone-free rate, hemoglobin deficit, operative time, length of hospital stay, and early postoperative complications. Results Data of 40 patients were gathered. All the procedures were in prone position through two accesses. Results showed no significant difference regarding operative times. The immediate overall stone-free rate was 90%. Regarding hemoglobin deficit was 0.54 ± 0.3 g/dl. The rate of postoperative complications was four (10%) cases. Conclusion Counter-irrigation in mini-PCNL is effective for lessening postoperative fever.
Elgendy et al. (Wed,) studied this question.