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 third year of publication for PCNL data and whilst there is insufficient information for risk adjustment of every case we have published the 'average patient' profile for each consultant and hospital as regards certain risk factors, ( stone complexity, size and other medical problems), that we believe can affect the outcome of PCNL in terms of complications, length of stay and the likelihood of requiring a transfusion. This can indicate whether the hospital / surgeon operates on high-risk patients or, in fact, 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 reliably validating the data other than by comparing with Hospital Episode Statistics (HES); unfortunately, HES data is not reliable for PCNL, because procedures are coded differently in some hospitals. We are currently investigating how to make this coding more accurate in the future.
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.