Infectious complications following percutaneous nephrolithotomy (PCNL) persists as a serious concern and may lead to life-threatening sepsis syndrome. While having a negative urine culture entering the operating room lessens the chance of this from occurring, infected urine may persist within an obstructed system vis-a-vis infected renal stones. Most of these procedures are abruptly aborted if the urine appears turbid and dirty. We present a novel technique of renal irrigation to prevent septic complications during PCNL.

A 62-year-old diabetic female with obstructing renal pelvic stone underwent a PCNL. Another patient is an 81-year-old male known case of non-muscle invasive bladder cancer, gouty arthritis and was noted with a staghorn calculus. Intraoperatively, we both encountered turbid urine with sediments despite a negative pre-operative culture. We incorporated gentamycin into the irrigant solution during the PCNL, followed by continuous irrigation via a nephrostomy tube postoperatively for 24 hours. The operative time lasted 100 minutes with minimal blood loss. They had an unremarkable postoperative course.

 

Intraoperative and postoperative antibiotic renal irrigation is a potential adjunct to prevent septic complications of PCNL.