Percutaneous renal stone manipulation--a nonoperative alternative.

Nephrostomy tube tracts, established operatively or percutaneously, can provide access to stones in the upper urinary tract. A variety of rigid or flexible urologic instruments can be used to percutaneously disintegrate or extract calculi, thus sparing a patient an operative procedure. This is most important in the case of high-risk patients, those previously operated upon or those who have active nephrolithiasis, in whom recurrent stones are prone to form. Our early experience in percutaneous renal stone disintegration and stone manipulation enabled us to remove most (in four patients) or all (again in four patients) calculi in nine patients. The procedure offers lower morbidity, shorter hospital stay and earlier return to employment than conventional operative stone procedures.