Renal stone is a very common disease that affects 5.8% of the population in China . Percutaneous nephrolithotomy (PCNL) is considered as the most efficient treatment for renal calculi that are ≥ 2 cm in diameter, providing high stone-free rate and rapid recovery
Larger renal stones or positive urine nitrite tied to delayed discharge after day-surgery percutaneous nephrolithotomy (PCNL) suggests a recent study published in the BMC urology. However reducing surgery time and nephrostomy tubes will help to facilitate recovery.

Day-surgery percutaneous nephrolithotomy (PCNL) is being developed quickly but some potential factors are affecting the recovery process. This study is aim to analyze the reasons and risk factors for delayed discharge after day-surgery PCNL.
The data of 205 patients who accepted day-surgery PCNL in our institution between January 2018 and February 2020 were analyzed, retrospectively. Univariate and multivariate logistic regression analysis were used to analyze the risk factors for delayed discharge. Besides, the nomogram prediction model was established by the multivariable logistic regression analysis.
Results
• The rate of delayed discharge was 14.6%. Independent risk factors for delayed discharge were larger stone burden, positive urine nitrite, longer duration of surgery, multiple nephrostomy tubes
• The five main reasons that caused delayed discharge included psychological reasons, pain, bleeding, urosepsis, and urine leakage.
This study identified some independent risk factors for a hospital length of stay longer than 24 h. Patients with larger renal stones or positive urine nitrite may be at increased risk of delayed discharge after day-surgery PCNL. Reducing surgery time and nephrostomy tubes will help to facilitate recovery.
In all four independent risk factors for delayed discharge after day-surgery were identified: larger stone burden, positive urine nitrite, longer duration of surgery, and multiple nephrostomy tubes. Therefore, patients with large renal stones or positive NIT may be at increased risk of delayed discharge. Shortening surgery time and reducing the number of nephrostomy tubes will help to facilitate recovery.
Reference:
Zhu, H., Liu, B., Karagöz, M.A. et al. Reasons and risk factors for delayed discharge after day-surgery percutaneous nephrolithotomy. BMC Urol 22, 209 (2022). https://doi.org/10.1186/s12894-022-01159-5