Vol. 9, Issue 1, Part D (2025)

Background: Percutaneous nephrolithotomy (PCNL) is a standard treatment for large or complex kidney stones. Traditionally, a nephrostomy tube is placed postoperatively, but tubeless PCNL has been reconsidered for select patients, offering benefits such as reduced pain, shorter hospital stays, and lower urine extravasation rates. This study evaluates the role of Surgiflo in tubeless PCNL compared to standard PCNL.

Methods: A total of 144 patients undergoing PCNL at Al Yarmouk Teaching Hospital from January 2022 to January 2024 were included. After excluding patients lost to follow-up, 62 patients underwent standard PCNL, and 62 underwent tubeless PCNL with Surgiflo application. Preoperative laboratory investigations were performed for all patients. Outcomes assessed included postoperative urine leakage, pain, analgesic use, and hospital stay.

Results: The mean age was similar between groups (44.4±11.8 vs. 42.1±12.2 years). The mean stone size was 3.7±0.7 cm for standard PCNL and 3.6±0.7 cm for tubeless PCNL. There was no significant difference in hemoglobin reduction (1.3±0.5 vs. 1.2±0.4, p>0.05) or operative time (65±12.6 vs. 67±11.6 min, p>0.05). Urine leakage was significantly lower in the tubeless group (3.2% vs. 96.8%, p=0.0001). Postoperative pain and analgesia requirements were significantly lower in the tubeless group on days 0 and 1 (p=0.0001). Hospital stay was shorter in the tubeless group, with 80% discharged on the same day.

Conclusion: Surgiflo application in tubeless PCNL significantly reduces urinary leakage, postoperative pain, and hospital stay while minimizing analgesic use, making it a viable alternative to standard PCNL.