Gaudji B.G, Moshokoa E.M, Bornman M.S, Becker P. Department of ...

Gaudji B.G, Moshokoa E.M, Bornman M.S, Becker P.
Department of Urology
University of Pretoria
South Africa

Percutaneous nephrolithotomy (PCNL) is
regarded as the most challenging and
morbid of minimally invasive surgery for
kidney stone removal¹.
Increasing prevalence of upper urinary tract
stone diseases in South Africa, especially at
SBAH, due to lifestyle changes across
different racial groups².
report on :
Nature and variety of stone burden;
Operating time, Morbidity, stone clearance;
Retreatment;
Cost.

Retrospective study based on 106 patients
PCNL and URS with laser for upper urinary
calculi between 2008 and 2012
PCNL and URS disposable kits
Holmium Laser(sphinx)³
Disease characteristics, intra-operative and
post-operative data were reported
Estimated cost was for hiring flexible URS with
laser and consumables.

Pre-OP Post-OP
P21
Average Stone burden = 2cm –8cm

Pre-OP Post-OP

Pre-OP
Post-OP

P36
Pre-OP Post-OP

Pre-OP Post-OP
P71

Pre-OP P79 Post-OP

Gender 14 females
42 males
PCNL URS
19 females
31 males
Operating Time 166.30 ± 50,40 min 110 ± 22.9min p

PCNL :
Longer operating time and higher morbidity
Higher stone clearance
Lower cost
URS with Laser:
Lower morbidity and shorter hospital stay
Lower stone clearance with higher retreatment rate
Higher cost including disposable equipment
At this point of time, PCNL seems more effective in terms of
stone clearance and cost.
These findings will assist to setup a stone center and to
implement effective management and policy for endo-
urological procedures, based on adequate risks assessment for
surgical outcome� .
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Dr Cilliers . D
Dr Van Heerden .I
Dr Engelbrecht .T