Postoperative Pain and Recovery Outcomes Following Tubeless versus Standard PCNL

Author(s): Dr. S M Yunus Ali, Dr. Kamrun Nahar, Dr. Md. Mostafizur Rahaman, Dr. Md. Immam Hossin, Prof. Dr. Md. Saiful Islam, Dr. Md. Rasel Ahmad.

Background: Urinary stones are a common urological condition that can impair renal function and pose a significant public health concern, with prevalence rates ranging from 1% to 20% and higher rates (>10%) in developed countries. The purpose of this study is to compare postoperative pain and recovery outcomes between tubeless and standard percutaneous nephrolithotomy in our patient population, addressing a critical gap in current clinical evidence. Methods: This prospective RCT at the Department of Urology, Bangladesh Medical University Hospital, Dhaka, enrolled 100 adults with large renal stones (>2 cm) to compare Tubeless and Standard PCNL. Outcomes included postoperative pain, hospital stay, 30-day complications, stone-free status at 3 months, and recurrence at 12 months. Data were collected by blinded assistants, analyzed using appropriate statistical tests (p < 0.05). Results: In 100 patients, baseline characteristics were comparable. Tubeless PCNL showed lower postoperative pain (VAS 3.9–1.8 vs 5.8–3.1, 6–48 h), shorter hospital stay (1.6 ± 0.8 vs 3.2 ± 1.1 days, p < 0.001), and fewer overall complications (14.0% vs 44.0%, p = 0.002), with significantly less urinary leakage (2.0% vs 14.0%, p = 0.03). Conclusion: Tubeless PCNL provides faster recovery, less postoperative pain, and fewer complications than standard PCNL.