PCNL in Italy

Introduction: The first italian meeting on percutaneous nephrolithotomy (PCNL) was held in Milan in 1984. Since then PCNL has been practised in many centres but its diffusion has not been fast. Material and methods: A Medline search using as keywords: PCNL, Percutaneous nephrolithotomy, Percutaneous surgery, was performed, time limits 1983 to 2008 to look for contribution of italian authors in indexed journals. The proceeding and abstract book of the SIU (Società Italiana di Urologia) from 1984 were consulted to ascertain the number of communications presented to the italian national congress. The number of PCNL performed and hospital stay in Italy are official data from the Ministero della Salute website www.ministerosalute.it. Results and discussion: The number of papers published by italian authors on indexed journals, although of good quality, has been poor in the past but is rising in recent years. Also from the proceedings of the italian urological association an increase in the interest for PCNL is testify by the growing number of communications presented to the national congress. Of the 2555 PCNL performed in 2005 in Italy, 2513 were inpatient procedures with a mean hospital stay of 8, 11 days. Even if the number of procedures/year is increasing still there is a wide difference among different italian regions and PCNL can be considered an underutilized procedure. Conclusions: It is mandatory to increase the number of educational courses on PCNL to increase the number of urologists performing this technique and in order to minimize hospital stay and to reduce the number of repeated extracorporeal lithotripsy for large burden stones and, most of all, the number of open procedures still performed.