Department of Urology, University Hospital of Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
EAU Young Academic Urologists (YAU) Urolithiasis and Endourology Working Group, Arnhem, The Netherlands.
World J Urol. 2022 Aug;40(8):2091-2098. doi: 10.1007/s00345-022-04067-3. Epub 2022 Jul 1.
To evaluate the current practice of percutaneous nephrolithotomy (PCNL), conducting a worldwide survey among urologists with a special interest in endo-urology.
A 22-question survey was specifically developed by the European Association of Urology (EAU) young academic urologists (YAU) and uro-technology (ESUT) groups and globally distributed via SurveyMonkey to almost 2000 members of Endourology Society. The questionnaire included questions dedicated to the demographics and general practice of the participating urologists.
In total, 441 responses (male/female ratio - 418/23) were received. A comparatively higher percentage of specialists (56.2%) practiced in academic institutions and had specific endo-urological fellowship training (56.7%). The classical prone PCNL remained the most practiced approach among the surveyed specialists, 47.7% stated to always do prone PCNLs, while 51.8% of respondents used multiple positioning options as required. The PCNL tract was mostly performed by urologists (84.3%) and fluoroscopic guidance was still predominantly used by 74.5% of respondents. The most practiced tract dilation method was balloon dilator used by 42% of respondents. Most of the surveyed urologists had ultrasonic, pneumatic or laser lithotripsy devices in their armamentarium. The use of some form of post-procedural drainage was reported in 85.1% of respondents, whereas tubeless PCNL remained a fairly uncommon practice.
The majority of urologists still use prone positioning, get their own access under fluoroscopy guidance and use a balloon for tract dilation. However, we also identified that when necessary, urologists will deviate from routine practice and change strategy, adopting other approaches for PCNL.
评估经皮肾镜取石术（PCNL）的当前实践，对专门从事内镜泌尿外科的泌尿科医生进行全球调查。
由欧洲泌尿外科学会（EAU）青年泌尿外科医生（YAU）和泌尿技术（ESUT）小组专门开发了一个 22 个问题的调查问卷，并通过 SurveyMonkey 在全球范围内分发给近 2000 名内镜学会成员。问卷包括专门针对参与调查的泌尿科医生的人口统计学和一般实践的问题。
共收到 441 份回复（男/女比例为 418/23）。在从事专科工作的医生中，较高比例的是专家（56.2%），他们在学术机构工作，并接受过特定的内镜泌尿外科专科培训（56.7%）。经典的俯卧位 PCNL 仍然是接受调查的专家中最常采用的方法，47.7%的人表示总是进行俯卧位 PCNL，而 51.8%的受访者根据需要使用多种定位选择。PCNL 通道主要由泌尿科医生进行（84.3%），74.5%的受访者仍主要使用荧光透视引导。最常采用的通道扩张方法是球囊扩张器，有 42%的受访者采用。大多数接受调查的泌尿科医生都有超声、气动或激光碎石设备。85.1%的受访者报告使用某种形式的术后引流，而无管 PCNL 仍然是一种相当少见的做法。
大多数泌尿科医生仍然采用俯卧位，在荧光透视引导下获得自己的通道，并使用球囊进行通道扩张。然而，我们还发现，当需要时，泌尿科医生会偏离常规实践并改变策略，采用其他 PCNL 方法。
