OUTCOME OF UPPER POLE PERCUTANEOUS NEPHROLITHOTOMY (PCNL) IN PRONE POSITION

Abstract

OBJECTIVE

To determine the outcome of upper pole percutaneous nephrolithotomy in prone position in terms of stone clearance and occurrence of complications.

METHODOLOGY

This descriptive cross-sectional study was conducted in the Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, over six months. A total of 43 patients aged 18–60 years with renal stones larger than 2cm undergoing upper pole PCNL in the prone position were included through consecutive non-probability sampling. Data on demographics stone clearance and procedure-related complications were recorded using a structured proforma. Statistical analysis was performed using SPSS 26 with p ≤ 0.05 as significant.

RESULTS

In a cohort of 43 patients (mean age 32.86 ± 10.33 years; 62.8% male), prone upper pole PCNL achieved a stone-free rate of 83.7%. Stone size and Hounsfield unit values were significantly associated with clearance outcomes, while postoperative haemoglobin and creatinine changes were statistically significant (p < 0.05), indicating measurable physiological impact.

CONCLUSION

This study shows that upper pole PCNL in the prone position can achieve strong stone clearance outcomes with a manageable risk of complications when performed with careful imaging guidance and attention to anatomy. The dimensions and density of the calculi significantly influenced the success of clearance. however, the overall outcomes were notably positive. These results advocate for the sustained application of prone access to the upper pole as a dependable strategy for the management of moderate to complex nephrolithiasis