Fourteen-Year Analysis of Percutaneous Nephrolithotripsy Outcomes: Evolution of Technique and Future Perspectives

PURPOSE: The treatment of kidney stones has undergone continuous evolution. Despite the evolution of retrograde intrarenal surgery, percutaneous nephrolithotomy (PNL) remains the gold standard treatment for large and complex stones. We aimed to evaluate and analyze the temporal evolution of the results of the PNLs conducted at two teaching hospitals. RESULTS: Data from 2660 patients were studied between 2009 and 2022. The rate of complex stones (Guy's 3 and 4) was 55.3%. Supine position was used in 82.1% of the cases. In 74.7% of cases, only 1 puncture was performed. The median surgery time was 120 min (15-240 min). The overall complication rate was 12.2%, the transfusion rate was 4.5%, and the success rate was 59.8%. Regarding temporal evolution, the use of the supine position increased from 73% in 2009 to 100% in 2022 (p < 0.001). The use of nephrostomy dropped from 81.8% to 26.5% (p