Our experience of Prone Versus Supine Percutaneous Nephrolithotomy

Abstract

Objective: To compare the effectiveness of percutaneous nephrolithotomy (PCNL) performed in prone and supine positions.

Study Design: Randomized clinical trial study.

Place and Duration of Study: This study was conducted at the Urology department of Bakhtawar Amin Medical and Dental Collage, Multan, Pakistan from 1st July 2022 to 30th June 2024.

Methods: A total of 200 patients who underwent PCNL in either prone or supine positions were enrolled. Patients with stones larger than 2 centimeters or those who had failed shock wave lithotripsy (SWL) therapies Follow-up was completed by 200 patients, among whom 100 underwent prone PCNL and 100 underwent supine PCNL, with the surgical position determined by the surgeon's preference.

Results: The mean operative time of Group A was greater than Group B, 77.63±3.66 minutes and 72.47±12.87 minutes, respectively. (p<0.001). Analgesia during procedure was given 43 (43.0%) to Group A and 29 (29.0%) to Group B, (p=0.039). The mean length of hospital stays of Group A was greater than the Group B, 62.13±3.69 hours and 52.96±10.36 hours, respectively, (p<0.001).

Conclusion: Performing PCNL in the supine position offers several advantages over the traditional prone position. Supine PCNL leads to shorter operating times, decreased hospital stays, and reduced analgesia requirements compared to prone PCNL