Neurologic complications in percutaneous nephrolithotomy

Abbas Basiri, Mohammad Hossein Soltani, Mohammadreza Kamranmanesh, Ali Tabibi, Seyed Amir Mohsen Ziaee, Akbar Nouralizadeh, Farzaneh Sharifiaghdas, Mahtab Poorzamani, Babak Gharaei, Ardalan Ozhand, Alireza Lashay, Ali Ahanian, Alireza Aminsharifi, Mehrdad Mohammadi Sichani, Mohammad Asl-Zare, Faramarz Mohammad Ali Beigi, Vahid Najjaran, Mehdi Abedinzadeh, Mohammad Masoud Nikkar

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


Purpose: Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. Materials and Methods: We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. Results: The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. Conclusions: It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection.

Original languageEnglish (US)
Pages (from-to)172-176
Number of pages5
JournalKorean Journal of Urology
Issue number3
StatePublished - Mar 2013

All Science Journal Classification (ASJC) codes

  • Urology


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