Can Doppler ultrasound reduce hemorrhagic complications in ultrasound-guided percutaneous nephrolithotomy for solitary kidney stones?

Purpose To evaluate the role of Doppler ultrasound in reducing hemorrhagic events during percutaneous nephrolithotomy (PCNL) in solitary kidney calculi through a comparative analysis. Patients and methods We retrospectively reviewed the charts of urolithiasis patients who had undergone ultrasound-guided PCNL in our department from March 2021 to December 2024 and identified 76 eligible patients. Patients were stratified into two cohorts based on Doppler flow detection technology application: Group 1 (Doppler-mode, n=29) and Group 2 (conventional mode, n=47）.Relevant patient characteristics, operative variables, and postoperative data were collected and analyzed, focusing on bleeding complications and stone-free rate(SFR). Results No significant difference was found between the two groups regards to basic characteristics(gender, age, body mass index, stone size, pre-operative serum creatinine). The puncture time shows significant longer in Group 1 compared to Group 2( 173.1±39.6s vs 111.4±29.9s, p=0.02). However, the hemoglobin loss reveals no significant difference between the two groups( 17.5±5.6g/L vs 21.7±6.3 g/L，p=0.19). There were no significant differences in the operation duration(p=0.47), transfusion rate(p=0.15), postoperative creatinine(p=0.80), overall complication(p=0.07), final stone-free rates(p=0.38) between the two groups. Conclusion Doppler flow technology fails to confer superior benefits in ultrasound-guided PCNL for solitary renal calculus, with no definitive necessity established for hemorrhage risk mitigation.