Percutaneous nephrostolithotomy and lithotripsy: a multi-institutional survey of complications.

A mail survey tabulating the results of some 8,595 percutaneous nephrostolithotomy and lithotripsy procedures (from 62 institutions) establishes an overall rate of failure, aborted procedure, and complications of 26% (2,262 cases). Data stratified as to the level of experience indicate a sharp improvement of the rate of failure and complications from 61% during the learning period to 18% thereafter. Inexperience and faulty technique rate highest as a cause for failure or complication. Underlying pathologic conditions and anatomic variants, while a relatively rare cause of failure or complication, can be diagnosed preoperatively and appropriate modification of technique instituted. The impact of technical factors such as the size of the postoperative nephrostomy tube is shown by statistical data.