Traditionally, in patients with bilateral stones, more symptomatic side had been operated initially, but in the past few years much effort has been done to operate both sides simultaneously. My question is about your experiences in bilateral single session PCNL. Do you recommend it to your patients?
I am sorry! I am a veterinary, so I do not have any patients. My research is in experimental surgeries in animal models, mainly in urogenital.
Yes, I do perform simultaneous bilateral PCNL (SBPN) regularly, I have performed about 200 cases till now. In my experience it is a feasible procedure in experienced hands. I started the SBPN when I was over 1000 PCNL procedure.
Indication: if PCNL is indicated on both sides. Do not choose too complicated stones .We planned to perform SBPN if the estimated operative time was within 2 hours.
Optimally the urine should be sterile, otherwise you may infect the healthy kidney with the ureteral catheter
I insert ureteral catheter for both sides and isolate both kidneys.
I start with the more complicated stones or the more symptomatic side.
If the first side is completed smoothly - no prolonged procedure, severe bleeding, residual stones - than continue with the other side.
The patient stay on the same position, We only move the fluoroscope to the other side. Use separate nephroscopic set if it is possible.
Do not take any unnecessary risk! If there is any complication than put a nephrostomy tube and postpone the further procedure for a few days later.
If you have any question, do not hesitate to contact me.
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