Abstract
Objective: To compare single-step dilatation technique with the stepwise (serial) dilatation technique in order to create a nephrostomy tract during percutaneous nephrolithotomy.
Methodology: This comparative interventional single-center study was conducted from May 2020 to November 2021 at Basra Teaching Hospital, Iraq. Fifty patients in group A underwent the single-step dilatation and 70 patients in group B were subjected to the stepwise dilatation technique in percutaneous nephrolithotomy. We recorded number of punctures, operation time, complications and success.
Results: There were no significant statistical differences in both groups regarding success rate, hospital stay, intra and postoperative complications, and bleeding that required blood transfusion. The stepwise dilatation technique had a considerably longer mean dilatation time than the single-step method did. The single-step dilatation technique had a much shorter mean radiation exposure a shorter mean total operating time than the stepwise strategy.
Conclusion: The construction and dilatation of a percutaneous nephrolithotomy nephrostomy tract can be successfully carried out using a single-step dilatation procedure, which requires less radiation exposure, less time during surgery, and shorter dilatation time.

Key words: Single–step dilatation, stepwise dilatation technique, percutaneous nephrolithotomy.