investigating the factors related to the amount of bleeding due to percutaneous nephrolithotomy (pcnl)

Background :hemorrhage remains a major concern during percutaneous nephrolithotomy (pcnl). the present study focused on determining the contributing factors to blood loss throughout the procedure. methods :in this prospective study, we assessed 412 individuals who underwent pcnl at our center from june 2020 to june 2024. hemoglobin drop post-surgery, adjusted for transfused blood volume, was used to estimate total blood loss. a stepwise multivariate regression model was applied to explore the correlations between bleeding volume or transfusion requirement and multiple patient-specific or procedural variables. results :the average hemoglobin reduction observed was 1.57 ± 2.43 g/dl. significant predictors of blood loss included body mass index (bmi) (p < 0.05), stone dimensions (p < 0.05), presence of multiple stones (p < 0.05), upper calyceal stone location (p < 0.05), insertion of two or more nephrostomy tubes (p < 0.05), surgery duration (p < 0.05), and diabetes (p < 0.05). a transfusion was required in 3.5% of patients. conclusions :increased intraoperative blood loss following pcnl was significantly associated with higher bmi, greater stone burden, multiple stones, upper calyceal location, prolonged surgical time, multiple nephrostomy insertions, and diabetes mellitus.