Is it necessary to have a guidewire down through the ureter during mini percutaneous nephrolithotomy? Single center experience with 1052 cases.

Objectives In this study it is aimed to identify the rate of successful placement of a guidewire down through the ureter during PNL and to compare the outcomes of different locations of guidewires in the collecting system following renal puncture in terms of success and complications rates. Patients and methods Data of 1052 patients underwent miniPNL in our institution between January 2014 and November 2020 was analyzed. Patients were divided in to three groups. Group I consisted of patients with the guidewire coiled within the punctured calyx. Group II consisted of patients with the guidewire reached the renal pelvis, and Group III consisted of patients with the guide wire passed down through the ureter. The groups were compared for successful tract creation and complication rates. Results There were 303 (28.8%) patients in group I, 330 (31.4%) patients in group II and 419 (39.8%) patients in group III. Successful tract dilation at the first attempt was established in 298 (94.7%) patients in group I, 328 (99.4%) patients in group II, and in all of the 419 (100%) patients in group III. Successful tract creation was established in a second attempt in all of the patients failed in the first attempt. The groups were similar for stone free and complication rates. Conclusions Placement of guidewire down through the ureter could not be established in more than 60% of the cases. Location of guidewire prior to dilation did not affect the outcomes. Therefore, we suggest to proceed with tract creation even when the guidewire coils within the punctured calyx.