Retrograde percutaneous nephrostolithotomy: an acceptable alternative to antegrade techniques.

Retrograde percutaneous nephrostolithotomy was attempted by the urology service in 28 patients. Renal access was achieved with the standard Lawson retrograde nephrostomy set. Tract dilation was performed over the 0.017-inch puncture wire. Successful renal access was achieved in 28 of 30 kidneys (93 per cent) and in 1 session the targeted stone was removed in 26 (87 per cent). Two patients failed the retrograde technique and underwent successful antegrade stone removal under the same anesthesia. Two patients required open stone removal. No patient required a second percutaneous procedure for incomplete stone removal, no major bleeding episodes occurred and no complications requiring surgical intervention were encountered. The technique of retrograde percutaneous nephrostolithotomy is a safe and reliable means to achieve precise, atraumatic intrarenal access. It is easy to learn and does not require the expertise of a trained radiologist.