COMPARISON OF UNILATERAL VS BILATERAL PCNL FOR BILATERAL RENAL STONES WHICH ONE WORTH THE MOST?

Abstract

BACKGROUND: In urology clinics, the most prevalent and recorded cases are the urinary tract stones.  Multiple treatment choices exist to treat these renal stones and among them percutaneous Nephrolithotomy is the most considerate one. This study aims to evaluate and compare the outcomes of unilateral and bilateral percutaneous nephrolithotomy (PCNL) for patients presenting with large and extensive bilateral renal stones, in order to determine the more efficacious approach. METHODOLOGY: An observational retrospective cohort study enlisting 120 patients who underwent PCNL from January 1^st 2024 to April 30^th 2024. with the participants divided into two groups, each consisting of 60 individuals where one group had unilateral PCNL while the other had simultaneous bilateral PCNL. The variables of study include age, gender, BMI, laboratory parameters, hospital stay, operative time, number of stone, approach of procedure, insertion of nephrostomy tube, stone clearance, post-operative complications, need of blood transfusion and need of ancillary procedures. RESULTS: Among 120 patients, the mean age was 39.1±13.7 years ranging from a minimum of 17 years to a maximum of 76 years. Male were 68(56.7%) while females were 42(43.3%). The results of both groups are identical in terms of stone clearance, rate of complications and need of blood transfusion and ancillary procedures and no major difference was noted in both groups. CONCLUSION: The cost-effectiveness, reduced hospitalization, and faster return to normal activities indicated a clear advantage for Simultaneous Bilateral PCNL compared to unilateral PCNL, suggesting it as a viable alternative for patients with stones in both kidneys.