Percutaneous Nephrolithotomy: Burden or Opportunity

摘要

In this issue of The Journal Morris et al (page 242) report that a greater percentage of percutaneous nephroli-thotomies (PNLs) are shifting to tertiary centers and further characterize this shift as an "increasing burden of care." They raise some interesting questions about PNL that are worth reviewing. One observation is that more PNLs are being done. Furthermore, the American Board of Urology reports that the number of PNLs being performed by residents in training has doubled in the last decade. Reasons for this trend may include an increase in the incidence of stone disease, a decrease in the effectiveness of shock wave lithotripsy, and/or improved techniques and comfort with PNL. This last point is the subject of Watterson et al's contribution in the current issue of The Journal (page 000) about the reduced rate of complications with PNL when access is performed by the urologist.