https://doi.org/10.1177/2051415819888083 Journal of Clinical Urology 1–7 © British Association of Urological Surgeons 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2051415819888083 journals.sagepub.com/home/uro Punctures versus shocks: a comparison of renal functional and structural changes after percutaneous nephrolithotomy and shockwave lithotripsy for solitary renal stone Nitin Shrivastava 1 , Brusabhanu Nayak 2 , Prabhjot Singh 2 , Prem N Dogra 2 , Rakesh Kumar 3 and Maroof A Khan 4 Abstract Objective: To evaluate renal functional and structural changes following percutaneous nephrolithotomy and shockwave lithotripsy for solitary non-obstructing non-staghorn renal stone. Materials and methods: Patients with solitary unilateral non-staghorn renal stones who were planned for percutaneous nephrolithotomy (20 patients) and shockwave lithotripsy (20 patients) were prospectively evaluated for renal functional and structural changes 60 days after the procedure and complete clearance of stones. Tc99-dimercaptosuccinic acid was used to assess cortical scarring and Tc99-diethylenetriamine pentaacetic acid and Tc99-levo levo ethylecysteine were used for glomerular filtration rate calculations, respectively. Results: The mean stone size was 24.4 mm and 13.7 mm in the percutaneous nephrolithotomy group and the shockwave lithotripsy group, respectively. No new cortical scars developed in either of the groups on Tc99-dimercaptosuccinic acid scan. Both the treated and untreated kidneys showed an overall insignificant fall in glomerular filtration rate in both the groups. The number of patients showing significant deterioration in the individual glomerular filtration rate in both the treated and untreated renal unit was more in the shockwave lithotripsy group. Conclusion: Both percutaneous nephrolithotomy and shockwave lithotripsy are comparable in terms of adverse effects on renal parenchyma and renal function. Level of evidence: Not applicable for this multicentre audit. Keywords Shockwave lithotripsy, percutaneous nephrolithotomy, glomerular filtration rate, renal function, renal stone Date received: 12 August 2019; accepted: 9 October 2019 1 Department of Urology, Oxford University Hospitals NHS Foundation Trust, UK 2 Department of Urology, All India Institute of Medical Sciences, India 3 Department of Nuclear Medicine, All India Institute of Medical Sciences, India 4 Department of Biostatistics, All India Institute of Medical Sciences, India Corresponding author: Brusabhanu Nayak, Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110023, India. Email: brusabhanu@gmail.com 888083URO Journal of Clinical UrologyShrivastava et al. Case Series. Urolithiasis