Bilateral simultaneous percutaneous nephrolithotomy. A prospective feasibility study.

A prospective study was undertaken to assess the feasibility and safety of bilateral simultaneous percutaneous nephrolithotomy (BPNL) under single anesthesia. BPNL was attempted in 16 consecutive patients with upper tract urolithiasis suitable for percutaneous treatment bilaterally. Bilateral simultaneous PNL could be accomplished in 14 of 16 cases; the opposite side was abandoned in 2 due to technical reasons. The operating sides could be switched within a short period (15 min) by rotating the patient table by 180 degrees. The average total operating time and irrigation time was 83 and 43 min, respectively. A total of 29 tracts and 18 sessions were required for endourologic treatment of 28 units in 14 patients. There was no significant morbidity. Complete clearance was achieved in 11 of 14 patients; there was insignificant residue in 1, while 2 with major residue required adjunct JJ stenting and extra-corporeal shockwave lithotripsy. The average hospital stay was 5.4 days. After initial proficiency with endourology, preparedness for BPNL is advisable in all such cases.