About the Audit
Percutaneous nephrolithotomy (PCNL) is the removal of stones from the kidney or ureter using a small puncture in the skin of the affected side. Small instruments are then passed to break up and remove the stones. PCNL can be done with the patient lying prone (face down) or supine (face up).
Click for information about kidney stones, causes and treatments or download the PCNL information leaflet.
The Section of Endourology Executive Committee has taken the decision to keep the published data as simple as possible. We have, therefore, only listed the number of operations performed, together with blood transfusion rates and length of stay as the only outcome measures.
Cumulative data from previous years are available on the Data & Audit pages of the Professionals section.
Interpretation of the data
This is the fourth year of publication for PCNL data. Whilst there is insufficient information for risk adjustment of every case, we have published the "average patient" profile for each consultant and hospital with respect to certain risk factors (e.g. stone complexity, size and other medical problems), that we believe may affect the outcome of PCNL in terms of complications, length of stay and the likelihood of requiring blood transfusion. These factors can indicate whether the hospital/surgeon operates on "high-risk" patients or specialises in peforming complicated surgery.
The data presented is surgeon-reported, by entry into the BAUS Data & Audit System. There is, therefore, no method for accurate validation of the data other than by comparing with the latest Hospital Episode Statistics (HES). Unfortunately, HES data is not very reliable for PCNL, because procedures are coded differently in different hospitals. We are currently investigating how to make this coding more accurate.
There are no financial incentives (or sanctions) for hospitals and Trusts to support collection of PCNL data, and this may also account for the data being incomplete.
It is also important to note that as a result of the COVID-19 crisis some surgeons and units may have been unable to submit all or any of their 2019 data.