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Percutaneous Nephrolithotomy
(PCNL) for Kidney Stones

Home Endourology Percutaneous nephrolithotomy (PCNL)
Percutaneous Nephrolithotomy (PCNL)

Percutaneous Nephrolithotomy (PCNL)

Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure to remove large kidney stones that cannot pass on their own or are resistant to other treatments, such as shockwave lithotripsy. The procedure involves making a small incision in the back to create a passage into the kidney, then inserting a scope to break up and remove the stone.

Why PCNL is Performed

  • Large or Complex Stones: Preferred for very large stones (often > 2 cm) or staghorn calculi that fill the entire kidney.
  • Resistant Stones: Used when stones are hard or do not respond to treatments like shockwave lithotripsy or ureteroscopy.

When is PCNL Recommended?

  • Kidney stones > 2 cm
  • Multiple or staghorn calculi
  • Stones resistant to ESWL (shock wave lithotripsy)
  • Stones causing obstruction with infection or kidney damage
  • Hard stones not easily broken

Advantages

  • Higher stone clearance rates for large/complex stones
  • Minimally invasive compared to open surgery
  • Shorter hospital stay than traditional surgery

Most Ask

General Questions

PCNL is performed under general anaesthesia, so you should not feel pain during the operation. Some soreness around the small incision, discomfort, or fatigue may occur afterward. Your medical team will provide suitable pain relief and recovery instructions.

Recovery after PCNL depends on the stone’s size and complexity, the procedure performed, and your general health. Many patients gradually resume routine activities over one to two weeks, although recovery may take longer in some cases. Follow your urologist’s instructions about returning to work, exercise, and other activities.

PCNL is often considered when kidney stones exceed 20 mm or are complex in nature. The choice of treatment also depends on the stone’s position, structure, number, and the patient’s overall condition. Your urologist will assess these factors to determine the most suitable approach.

Some patients need a temporary drainage tube to help urine or fluid leave the kidney after surgery. Others may not require one, depending on the procedure and the condition of the urinary tract. Your surgeon will decide whether a tube is necessary and when it can be removed.

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