PCNL (Percutaneous Nephrolithotomy)
PCNL is a minimally invasive procedure to remove large kidney stones (>2cm) through a tiny incision in the back — offering complete stone clearance with rapid recovery.
Overview
Percutaneous Nephrolithotomy (PCNL) is the standard treatment for large, complex, or staghorn kidney stones that are too big for ESWL or RIRS. The procedure creates a small tract (about 1cm) from the skin directly into the kidney, through which a nephroscope is passed to visualise and fragment the stone using ultrasound, laser, or pneumatic energy.
Unlike open surgery, PCNL is performed through a single incision that requires only a small dressing. Stone clearance rates exceed 90% in a single session. Most patients stay in hospital for 1-2 days and resume normal activities within a week.
Causes
- Same as kidney stones — dehydration, dietary factors, family history, obesity, certain medical conditions.
Symptoms
- Same as kidney stones — severe flank pain, blood in urine, nausea, frequent urination, fever if infected.
Diagnosis
- CT KUB — essential for PCNL planning; shows stone size, location, and kidney anatomy
- Ultrasound — initial screening
- Blood tests — kidney function, coagulation profile
- Urine culture — must be sterile before PCNL to prevent sepsis
Treatment Options
Standard PCNL
Tract size ~24-30Fr. Nephroscope fragments large stones. Single session clearance for most stones.
Mini-PCNL
Tract size ~16-18Fr. Smaller incision, less bleeding, suitable for moderately sized stones.
Tubeless PCNL
No nephrostomy tube left after surgery. Faster recovery and less post-op pain.
Frequently Asked Questions
Is PCNL painful?
It's performed under general or spinal anaesthesia. Post-operative pain is managed with medication and most patients are comfortable within 24 hours.
How does PCNL compare to open surgery?
PCNL has dramatically less pain, shorter hospital stay (1-2 days vs 5-7), smaller scar, and faster return to work compared to open stone surgery.
Ready to Discuss Your Treatment?
Our pcnl (percutaneous nephrolithotomy) specialists in Kondapur are here to help. Most consultations available within 24 hours.