Wesley A. Mayer, MD, presented “PCNL Challenges: How to Keep the Train on the Rails” during the 28th Annual Innovations in Urologic Practice conference on September 22, 2024, in Denver, Colorado.
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How to cite: Mayer, Wesley A. “PCNL Challenges: How to Keep the Train on the Rails.” September 22, 2024. Accessed Nov 2024 . https://grandroundsinurology.com/pcnl-challenges-how-to-keep-the-train-on-the-rails/
PCNL Challenges: How to Keep the Train on the Rails – Summary
Wesley A. Mayer, MD, offers a comprehensive discussion on optimizing percutaneous nephrolithotomy (PCNL), focusing on minimizing complications, strategic planning, and adaptive surgical techniques.
In this 20-minute presentation, Dr. Mayer reviews indications for PCNL with updates on guidelines. Then, he stresses the importance of individualized treatment decisions. Mini PCNL is emphasized for challenging lower pole stones, and for smaller stones, balancing efficiency and patient outcomes.
Dr. Mayer stresses preoperative preparation, underscoring the value of detailed imaging. The choice of access (prone vs. supine) is tailored based on patient anatomy, stone location, and procedural requirements. The importance of a flexible and adaptive approach is stressed, with practical examples illustrating the decision-making process when encountering complications.
Lastly, Dr. Mayer underscores the importance of knowing when to continue versus when to safely abort a procedure, reflecting on the need for prudent judgment to optimize patient safety and surgical outcomes.
About The 28th Annual Innovations in Urologic Practice:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.
For further educational activities from this conference, visit our collection page.