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Urologists versus radiologists made PCNL tracts: the UK experience
Authors:Muhammad Z. Aslam  Ali Thwaini  Brian Duggan  Ammar Hameed  Colin Mulholland  Hugh O’Kane  Trevor Thompson
Affiliation:(1) Department of Urology, Belfast City Hospital, Belfast, UK;(2) Department of Urology, Altnagelvin Hospitals, Belfast, UK;(3) Ward A5, Urology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK
Abstract:We aim to explore the practice of who makes the PCNL tract in the UK and Northern Ireland as well as presenting our data for two different approaches to PCNL tracts in Northern Ireland. A national questionnaire survey was carried out across the National Health Services hospitals in UK. In addition, a retrospective analysis of 134 PCNL cases was carried out. Group I included 103 (77%) cases with urologist-made tracts, while group II included 31 (23%) cases with radiologists-made tracts. The survey suggested that 45% (42) of the hospitals adopted a radiologist-made tract, 44% (41) use urologist-made tract, while the remaining 11% (11) use both. Most of the radiologists’ performed tracts in our series were for complex cases. Failed access occurred in 6 (5.8%) in group I and none in Group II. The overall stone-free rate was 92 and 50% for group I and II, respectively. There is a better stone clearance rate in Group I (p = 0.0016). This however is likely to be attributed to the complexity of the cases in group II. However, urologist made percutaneous tract is safe and efficacious but a team approach with radiology is needed for more complex cases.
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