JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 46

46

Journal of Clinical Urology 11(1S)

Results: Of 9,139 PCNL's, 198 patients required blood
transfusion (2.2%). Significantly greater transfusion rates
were observed for more complex stones, larger stones,
larger renal access size, and preop Hb <120 (Table 1).
Underweight patients and patients with normal BMI had
higher transfusion rates when compared to overweight
and obese patients. No difference was observed with

patient position, patient comorbidity, or operator performing renal puncture.
Conclusions: Risk of transfusion after PCNL increases
with larger more complex stones and when larger renal
access size is used. Patients with low preoperative Hb
and with lower BMI may be at increased risk for
transfusion.

P4-12: Table 1

Operator Performing Renal Puncture
Radiology
Urology
Patient Position
Prone Position
Supine Position
Size of Renal Access
6-24 Fr
25-30 Fr
Stone Complexity (Guy's Stone Score)
I-II
III-IV
Stone Size
<2 cm
>2 cm
Comorbid Conditions
No
Yes
BMI
<25
>25
Pre-op Hb
<120
>120

Transfusion
Yes (%)

No

125 (2.3%)
68 (2%)

5428
3273

0.5

155 (2.3%)
36 (1.8%)

6539
2019

0.12

8 (0.8%)
87 (2.6%)

944
3304

0.001

83 (1.7%)
111 (2.9%)

4840
3768

0.0001

48 (1.5%)
144 (2.5%)

3089
5593

0.002

192 (2.2%)
6 (2.4%)

8696
245

0.8

45 (3.6%)
80 (2.2%)

1262
3717

0.007

16 (3.6%)
42 (1.9%)

432
2131

0.03

P4-13 Is PCNL changing in the UK - analysis
of 9500 cases from the BAUS PCNL registry
Finch W1, Armitage J2, Withington J4, Irving S1, Fowler
S3, Burgess N1, Wiseman O2
1Norfolk and Norwich University Hospitals, United Kingdom,
2Addenbrookes Hospital, Cambridge, UK, 3BAUS, 4Guy's Hospital,
London, UK

Introduction and Methods: PCNL indications and
techniques evolve. BAUS developed an online-registry in
January 2010 that now includes >9500 procedures. We
evaluate outcomes and practices in PCNL and compare
with previous analyses of the registry at 1000 and 5000
procedures to highlight significant changes in PCNL practice in the UK.

P value

Results: 9536 procedures were available for analysis and
compared with previous analyses of 1028 cases in 2011
and 5191 cases in 2015. Submission of cases has stabilised
at ~2,200 cases/yr. Most PCNL is still prone, but supine
continues to significantly increase from 5K analysis (22.4%
vs. 16.2, p=0.0001). Access by interventional radiologist
showed a small but significant decrease from 5K analysis
(63.3% vs. 66.3%, p=0.0004), but not significantly different
from 1K analysis. No significant changes in tract dilatation
methods are seen, with balloon dilatation most popular
(64.3%). Consultants increasingly perform PCNL themselves rather than their trainees (96.5% vs. 84.4% (5K) vs.
79.0% (1k), p=0.0001). Laser fragmentation usage has significantly increased (9.4% vs. 7.0% (5K) vs. 5.8% (1k),
p=0.0001), with similar usage of ultrasound/lithoclast/lift
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