A clinical study of percutaneous nephroureterolithotripsy.

Percutaneous nephroureterolithotripsy was performed a total of 309 times in 225 renal units of 209 patients with upper urinary tract calculi, a mean of 1.37 times per kidney. Residual calculi, 5 mm or greater in diameter, were observed in 3 of 100 kidneys (3%) with single calculi, 12 of 102 kidneys (11.8%) with multiple calculi, and 8 of 23 kidneys (34.8%) with staghorn calculi. The number of sessions, duration of nephrostomy, and the frequency of residual calculi were significantly higher in problem calculi, such as multiple, large and staghorn calculi, than in other calculus types. A combination of percutaneous nephroureterolithotripsy and extracorporeal shock wave lithotripsy was considered to be necessary to improve the efficiency of lithotripsy. Complications included a transient fever, bleeding requiring transfusion and perforation of the renal pelvis in a small number of cases, but these were all mild and could be managed by conservative treatment, alone.