Choosing the appropriate size of Amplatz sheath during percutaneous nephrolithotomy-a novel method.

Objective: To choose appropriate size Amplatz sheath during percutaneous nephrolithotomy (PCNL) based on retrograde pyelogram.

Material and methods: We performed standard PCNL in prone position in 20 patients. All these patients had placement of appropriate size of Amplatz sheath based on retrograde pyelogram images. All patients had nephrostomy tubes postoperatively. The preoperative and postoperative renal parameters, hemoglobin, mean operating time and mean hospitalisation stay were measured.

Results: There was no significant difference between the pre-operative and postoperative hemoglobin and creatinine levels. Median operating time was 60.5 mins (45 to 98 mins). The median hospitalisation stay was 4.6 days (3 to 7 days). There was no intraoperative pelvic wall or infundibular injury.

Conclusion: Choosing correct size of Amplatz sheath lowers the incidence of kidney hemorrhage and renal function impairment.