Predictors of salvage percutaneous nephrolithotomy: experience in 752 patients

Objectives To determine the predictors of salvage percutaneous nephrolithotomy (PNL). Patients and methods From March 2012 to July 2019, the medical records of 752 patients who underwent primary PNL were reviewed retrospectively; of whom 78 patients underwent second-look PNL. Patient demographic, stone characteristics, and the reasons for the failure of the previous PNL are studied. Results Seventy-eight patients out of 752 at our center underwent a second-look PNL. Indications for second-look PNL were residual stones in 54 (69.2%) patients, unsuitable access in nine (11.5%), bleeding (Clavien I/II - with or without transfusion) in eight (10.3%), pelvicalyceal perforation in four (5.1%) and turbid urine in three (3.8%). Conclusion Salvage PNL remains an important tool for treating residual renal calculi. Harder, significant residual stones and intraoperative complications necessitating rapid termination of the primary procedure might be the predictors for the need to salvage PNL.