Randomized comparison of patient outcomes following fluoroscopic guided PCNL versus ultrasound-guided PCNL.

This study is a randomized controlled trial that compares the operative outcomes and complications of fluoroscopic guided-percutaneous nephrolithotomy versus ultrasound-guided PCNL for renal stones. This study will be a prospective randomized controlled clinical trial with patients who have already agreed to undergo PCNL. Patients will be randomized at a 1:1 ratio to receive either PCNL under fluoroscopic guidance or PCNL under ultrasound guidance. Patients will be asked to complete pre-operative, and postoperative quality of life questionnaires, and to allow the collection of one additional vial of blood for measurement of factors associated with inflammation.

Inclusion Criteria:

• Patients planned for PCNL at participating institution
• Patients of all ethnic backgrounds
• Stone size over 10 mm in diameter and a density over 900 Hounsfield units
• Patients with a large calculus in the upper third of the ureter

Exclusion Criteria:

• Pregnancy
• infectious disease of the genitals;
• conditions that violate the configuration of the kidneys (curvature of the spinal column)
• anomalies in the development of the kidneys with impaired configuration and position of the kidneys (horseshoe kidney, bisque kidney, S-shaped kidney, L-shaped kidney, lumbar dystopia, iliac dystopia, pelvic dystopia)
• presence of nephrostomy drainage in the target kidney;
• urethral stricture or other reason leading to the inability to carry out ureteral catheterization;
• other conditions that are contraindications to surgical treatment, such as uncontrolled diabetes mellitus, acute cardiovascular conditions, liver failure, alcoholism, and drug addiction;
• patients who are unable to understand the purpose of the study or refuse further follow-up observation and instructions after treatment;
• patients with a history of mental illness;
• participation in another research that interferes with this research;
• acute renal failure;
• dissecting aortic aneurysm;
• acute hypertensive encephalopathy;
• heavy arterial bleeding;
• myocardial infarction less than six months before enrollment in the study;
• Stroke less than six months before enrollment in the study;
• Insufficiency of blood circulation III-IV New York Heart Association class;
• Severe rhythm and conduction disturbances;
• Increase in the level of liver transaminases by more than three times;