Ultrasonography-Guided Percutaneous Nephrolithotomy in the Flank Position Versus Fluoroscopy-Guided Percutaneous Nephrolithotomy in the Prone Position: A Comparative Study

Abstract Background and Purpose: Gaining access to the pyelocaliceal system in percutaneous nephrolithotomy (PCNL) is routinely performed using fluoroscopic guidance with the patient in a prone position. We compared ultrasonography-guided access for PCNL with the patient in the flank position with conventional fluoroscopy-guided access. Patients and Methods: A total of 60 patients were randomly separated into two 30-patient groups—namely, ultrasonography-guided access with the patient in the flank position as group 1, and fluoroscopy-guided access with the patient in the prone position as group 2. In group 1, the entire procedure was performed under ultrasonography guidance. Results: Successful access was achieved 100% in both groups. The success rate was 86.7% in group 1 and 90% in group 2 (P = 0.45). The residual stone rate (stone ≥4 mm) was 13.3% in group 1 and 10% in group 2. The access duration was 14.5 ± 2.6 minutes and 9.4 ± 2.3 minutes in groups 1 and 2, respectively (P < 0.05). No significant dif...