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Objective <p>To evaluate the feasibility and safety of omitting postoperative urinary catheter placement in patients undergoing percutaneous nephrolithotomy (PCNL) under paravertebral block (PVB) anesthesia without retrograde catheterization.</p> Methods <p>This retrospective study analyzed 197 eligible patients selected from an initial cohort of 248. All patients received PCNL under PVB. They were divided into two groups based on postoperative catheterization: Group 1 (without urinary catheter, <i>n</i> = 97) and Group 2 (with urinary catheter, <i>n</i> = 100). To minimize confounding factors, propensity score matching was performed based on the number of access tracts, resulting in two groups: Group A (without urinary catheter, <i>n</i> = 90) and Group B (with urinary catheter, <i>n</i> = 90). Preoperative baseline characteristics, perioperative parameters, and postoperative complications were compared between the groups.</p> Results <p>No significant differences were observed in age, gender, body mass index (BMI), comorbidities, stone characteristics, or preoperative laboratory findings between the two groups (<i>P</i> &gt; 0.05), indicating comparability. Regarding surgical efficacy and safety, there were no statistically significant differences in operative time, blood loss, number of access tracts, postoperative hemoglobin drop, inflammatory marker changes, or initial stone-free rate (<i>P</i> &gt; 0.05). Group A showed superior outcomes in several aspects: lower visual analog scale (VAS) pain scores (<i>P</i> &lt; 0.001), shorter postoperative hospital stay [3.00 (3.00, 4.00) vs. 4.00 (3.00, 4.00) days, <i>P</i> &lt; 0.001], lower incidence of postoperative urinary tract infection (2/90 vs. 10/90, <i>P</i> = 0.017), and lower overall postoperative complication rate (9/90 vs. 25/90,<i> P</i> &lt; 0.002).</p> Conclusion <p>For appropriately selected patients undergoing PCNL under PVB without retrograde catheterization, omitting the postoperative urinary catheter is a safe practice. This approach is associated with reduced postoperative pain, shorter hospitalization, and merits clinical consideration under standardized perioperative management.</p>

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Safety and feasibility of tubeless PCNL without urinary catheter or retrograde intubation under paravertebral block

  • 期刊论文

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  • 发表日期：

    2026年3月6日

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  • Guangyuan Yang,
  • Fuchao Liang,
  • Xiaosong Sun,
  • Linghui Qin

摘要

Objective

To evaluate the feasibility and safety of omitting postoperative urinary catheter placement in patients undergoing percutaneous nephrolithotomy (PCNL) under paravertebral block (PVB) anesthesia without retrograde catheterization.

Methods

This retrospective study analyzed 197 eligible patients selected from an initial cohort of 248. All patients received PCNL under PVB. They were divided into two groups based on postoperative catheterization: Group 1 (without urinary catheter, n = 97) and Group 2 (with urinary catheter, n = 100). To minimize confounding factors, propensity score matching was performed based on the number of access tracts, resulting in two groups: Group A (without urinary catheter, n = 90) and Group B (with urinary catheter, n = 90). Preoperative baseline characteristics, perioperative parameters, and postoperative complications were compared between the groups.

Results

No significant differences were observed in age, gender, body mass index (BMI), comorbidities, stone characteristics, or preoperative laboratory findings between the two groups (P > 0.05), indicating comparability. Regarding surgical efficacy and safety, there were no statistically significant differences in operative time, blood loss, number of access tracts, postoperative hemoglobin drop, inflammatory marker changes, or initial stone-free rate (P > 0.05). Group A showed superior outcomes in several aspects: lower visual analog scale (VAS) pain scores (P < 0.001), shorter postoperative hospital stay [3.00 (3.00, 4.00) vs. 4.00 (3.00, 4.00) days, P < 0.001], lower incidence of postoperative urinary tract infection (2/90 vs. 10/90, P = 0.017), and lower overall postoperative complication rate (9/90 vs. 25/90, P < 0.002).

Conclusion

For appropriately selected patients undergoing PCNL under PVB without retrograde catheterization, omitting the postoperative urinary catheter is a safe practice. This approach is associated with reduced postoperative pain, shorter hospitalization, and merits clinical consideration under standardized perioperative management.