الفهرس 
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Abstract
This study included 53 patients (34 male and 19 female) presented with renal stones amenable for percutaneous nephrolithotripsy who were presented to the urology department, El-Minia university hospital. They were divided in to two groups:
Group 1: include patients with single renal stone burden more than 2 cm.
Group 2: include patients with multiple and branched renal stones.
They were subjected to the following preoperative evaluations:
• Full history taking which include the main complaint and past history as previous operations.
• Clinical examination.
• Preoperative laboratory work up.
• Imaging studies as abdomenal Ultrasonography, plain urinary tract, multislice C.T with and without contrast, occasionally I.V.U and retrograde pyelography.
In our study, in group one, 75% had single renal pelvic stone, 17.9% had lower calyceal stone and 7.1% had middle renal calyceal stones while in group two, 48% had renal pelvic stones extending to lower calyx, 12% pelvic extending to lower and middle calyces and 40% had multiple renal stones.
In group 1, 35.7% of patients and in group 2, 40% had no previous renal procedures while 32.1% in group 1 and 28% of group 2 had previous open renal surgery, 17.9% of group 1 and 12% of group 2 had previous ESWL, and 14.3% in group 1 and 20% in group 2 had previous PNL. With Ultrasonography most of cases in both groups had severe hydronephrosis (46.4% in group 1 and 60% in group 2).
The lower posterior calyx was the site of puncture in most cases, and balloon dilatation was the common method for tract dilatation puncture in most of cases in both groups. Pneumatic lithotripsy was used for stone disintegration and different types of graspers were used for stone extraction. Nephrostomy tube was fixed at the end of the maneuver for drainage and was left for an average of 3-7 days postoperatively. The mean operative time in group 1 was 91.3 minute (range 50-145 minute) while group 2 it was 136.6 (range 55-205 minute).
Severe bleeding occurred in 3.7% in group 1 and 16% in group 2, while severe extravasations occurred in 8% in group 2 only.
The success rate in group 1 was 92.8% and in group 2 it was 88%. Two patients in group 1 and one patient in group 2 had ESWL later on, while the other two patients in group 2 were postponed for another PNL.
The nephrostomy tube was left for 3-4 days in most patients apart from two patients in group 2 where it was left for one week for second look PNL. The ureteral catheter was removed 2 days after removal of nephrostomy tube.
The hospital stay ranged from 3-4 days in group 1 and 3-7 days in group 2. The long period of hospital stay in some patients was for close observation of patients with complications or for second look PNL.
Our results are in great similarity with results in most literature.