Purpose of review: To provide an updated overview of different exit strategies for percutaneous nephrolithotomy (PCNL) in times of miniaturization and minimal invasive surgery.
Recent findings: The majority of the reported studies concluded that a tubeless procedure is associated with less patient discomfort and a shorter hospital stay compared to the standard PCNL. Additionally, no significant difference in the complication rate was observed, including postoperative fever, hematocrit decrease, stone-free rate, and urine extravasation.
Summary: Underlined by recent literature tubeless PCNL is a well tolerated and effective treatment. Nevertheless the decision whether or not to place a nephrostomy tube after PCNL is still depending on the clinical judgment and experience of the surgeon.