Comparison Between Tubeless and Tube Percutaneous Nephrolithotomies in Pediatric Population: A Randomized Controlled Trial

OBJECTIVES This study aimed to compare the efficacy and safety of tubeless versus conventional tube PCNL in pediatric patients with renal calculi >10mm. METHODOLOGY A randomized controlled trial conducted at Khyber Teaching Hospital, Peshawar (October 2024-Sep 2025). Six hundred forty pediatric patients (6-18 years) with kidney stones >10mm were randomly allocated to Group A (Tubeless PCNL, n=320) and Group B (Tube PCNL, n=320). A single experienced urologist performs the procedures. Primary outcomes, including operative time, hospital stay, blood transfusion requirements, and stone-free status, were measured. RESULTSGroups had similar baseline characteristics (mean ages 11.2±3.1 vs 11.4±3.2 years). Tubeless PCNL showed significantly shorter operative time (45±10 vs 50±12 minutes, p<0.01), reduced hospital stay (2.0±0.8 vs 2.5±1.0 days, p<0.01), lower blood transfusion requirements (7.8% vs 14.1%, p=0.02), and higher stone-free rates (95.3% vs 90.6%, p=0.04). CONCLUSION Tubeless PCNL demonstrated statistically and clinically significant advantages, including shorter operative times, reduced hospital stays, fewer transfusions, and higher stone-free rates, supporting its adoption as the preferred approach for pediatric renal calculi management.