Comparison one-step procedure with two-step procedure in percutaneous nephrolithotomy

Szu Han Chen, Wen Jeng Wu, Yii Her Chou, Hsin Chih Yeh, Chia Chun Tsai, Kuang Shun Chueh, Nien Ting Hou, Siou Jin Chiu, Hung Pin Tu, Ching Chia Li

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


The aim of this study was to compare the effects of one-step percutaneous nephrolithotomy (PCNL) by the urologist alone and two-step PCNL by cooperating with the radiologist. We included 168 patients who underwent surgery by the same surgeon, 83 who underwent two-step PCNL, in which percutaneous nephrostomy insertion was performed by the radiologists on the day before endo-surgery, and 85 who underwent one-step PCNL, which involved the creation of a nephrostomy tract and performing the PCNL at the same time in the operating room, by a urologist. We compared the perioperative and postoperative parameters between these two groups. The result revealed that there were no significant differences between one-step and two-step PCNL in the decreases in haemoglobin level and blood transfusion volume, and the hospital stay was shorter in the one-step PCNL group. In addition, the one-step PCNL group was associated with significantly lower visual analogue score (VAS), which were 2.3, 1.1, and 0.4 on the post-operative days 1, 2, and 3, respectively, compared with 3.2, 1.7, and 1.0 in the two-step PCNL group. The number of parenteral analgesic prescriptions was fewer in the one-step PCNL group (0.8 ± 1.1 amps/vials) than in the two-step PCNL group (4.1 ± 2.4 amps/vials). Furthermore, different stone locations barely affected VAS and analgesic administrations. The results indicate that the one-step PCNL by the urologist alone, compared to two-step PCNL with the radiologist, has better wound pain outcome and shorter hospital stay with comparable successful rate and complication grade.

Original languageEnglish (US)
Pages (from-to)121-126
Number of pages6
Issue number2
StatePublished - Apr 2014
Externally publishedYes


  • Complication
  • Percutaneous nephrolithotomy
  • Renal stone
  • Wound pain

ASJC Scopus subject areas

  • Urology


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