Comparative study between ultrasound versus fluoroscopy-guided access during percutaneous nephrolithotomy

Aim
To evaluate percutaneous nephrolithotripsy (PCNL) guided by ultrasound (UG) versus fluoroscopy (FG) comparing both techniques regarding operative time, success, and complication rates.


Patients and methods
This is a randomized study that was carried out from March 2019 to February 2020 on 50 patients divided into two groups: group I included 25 patients who were guided by fluoroscopy, and group II included 25 patients who were guided by ultrasound.


Results
Stone-free rate was 88% in group I (FG PCNL), whereas it was 72% in group II (UG PCNL). Mean operative time was 90 min in group I (FG PCNL) compared with 97 min in group II (UG PCNL), with P value 0.001. The complications were intraoperative bleeding in six (24%) patients in group I (FG PCNL) and two (8%) patients in group II (UG PCNL), and postoperative fever in four (16%) patients in group I (FG PCNL) compared with two (8%) patients in group II (UG PCNL), with P value 0.051.


Conclusion
PCNL under US guidance is accompanied by high success rates with few complications, similar to that of fluoroscopy-guided PCNL, with decrease exposure to radiation.