Electrocauterization of bleeding points for percutaneous nephrolithotomy

Objectives. To perform a retrospective study to assess the efficacy and safety of electrocauterization of bleeding points after stone extraction using the data from 249 percutaneous nephrolithotomies. Methods. A total of 341 percutaneous nephrolithotomies in 324 patients were performed at the Chiayi Christian Hospital from July 2000 to July 2003. Electrocauterization of bleeding points with an elongated electrode probe was performed in 249 patients. The age, height, weight, preoperative hemoglobin level, stone burden, operating time, stone free rate, length of postoperative hospital stay, postoperative urinary tract infection rate, and blood transfusion rate were recorded by retrospective chart review. Results. No statistically significant differences in age, height, weight, stone burden, operating time, stone free rate, or length of postoperative hospital stay were found between patients with or without electrocauterization. No increase occurred in the postoperative urinary tract infection rate in patients who received electrocauterization, and these patients had a statistically significant decrease in the transfusion rate. No nephrostomy tube was inserted at the completion of surgery in 84 (33.7%) of the 249 operations in which electrocauterization was performed. Conclusions. Electrocauterization of the bleeding points at the end of percutaneous renal surgery decreases the blood transfusion rate without causing an increase in morbidity. This procedure is safe and effective and may make more patients suitable for tubeless modification.