Supine versus prone PCNL in lower calyceal stone: Comparative study in a tertiary care center

Introduction: Renal calculus disease is an age old disease of human being. PCNL (Percutaneous nephrolithotomy) stands as a gold standard treatment for large renal calculus which is traditionally being done in prone position. Objective: To evaluate the safety and efficacy of supine PCNL versus prone PCNL comparing intraoperative time, requirement of relook PCNL, post op hemoglobin drop, post operative hospital stay, post operative complication, SFR ( stone free rate). Methods and materials: It is a prospective study done in Urology department in a tertiary care center in Eastern India between October 2017 and October 2018. A total of 84 patients with lower calyceal renal stones underwent PCNL, 42 of them in supine and 42 in prone position. Lower calyceal stone, size measuring 1 to 2 cm were included in the study. Results: The mean intra operative time was 91.76 min in supine group and 85.43 min in prone group with a p value of 0.115. The mean hemoglobin drop was 1.11 g/dl and 1.18 g/dl in supine and prone position, respectively ( p value 0.75). The mean post operative hospital stay was 4.1 and 3.86 days in supine and prone group ( p value 0.58), respectively. Two patients in each group require relook PCNL. Stone free rate at 1 month was 95.23% and 90.47% ( p value 0.9), respectively in case of supine and prone group. Conclusion: Supine PCNL is feasible, comparable to prone PCNL in respect to operative parameters with relatively higher stone free rate though statistically insignificant.