LAUSR

In this month’s BJUI, Armas-Phan et al. [1] report on a prospective observational trial of fluoroscopic vs ultrasound (US)-guided tract dilatation during percutaneous nephrolithotomy (PCNL). A total of 176 patients underwent successful initial US-only guided puncture; of these patients, 138 had US-only dilatation, while in 38 fluoroscopy was required. The authors found no difference in patient factors (e.g., age, gender, body mass index [BMI]) or stone factors (hydronephrosis, stone burden, number of tracts or puncture location). On multivariate analysis, US dilatation was more likely to be performed in the modified dorsal lithotomy position (compared to prone), but there was no significant difference in important outcomes such as stone clearance, complication rates or blood loss.