Re: El-Nahas et al.: Factors Affecting Stone-Free Rate and Complications of Percutaneous Nephrolithotomy for Treatment of Staghorn Stone (Urology 2012;79:1236-1241)

摘要

TO THE EDITOR:We appreciate the authors of this study.1 showing complete staghorn and secondary calculi as risk factors for the success of percutaneous nephrolithotomy (PCNL) in patients with staghorn stones. The complication rate was dependent on surgeon's experience and positive preoper-ative urine culture. However, some issues in their study require additional clarification.In this study, preoperative urinary tract infections were treated with culture-specific antibiotics for 5 days before PCNL, and no attempt was made to perform repeat cultures to determine whether the urine had become sterile. That would have been the ideal scenario before performing PCNL. Thus, many of their patients might have had partially treated urinary tract infections at surgery, leading to greater complication rates. To treat the infection of staghorn stones, antibiotics for a longer duration might be required.