Percutaneous Nephrolithotomy (PCNL)

What is PCNL?

Percutaneous Nephrolithotomy (PCNL) is a minimally invasive operation used to remove large or complex kidney stones. Rather than passing instruments through the bladder and ureter, a small incision (approximately 1 cm) is made in your back to allow direct access to the kidney.

Who may benefit?

PCNL is recommended for:

• Large kidney stones (usually greater than 2 cm)

• Multiple kidney stones

• Stones that are difficult to access or unlikely to be cleared with other treatments

What happens during surgery?

The procedure is performed under general anaesthetic. A small tract is created using an X-Ray machine to guide a puncture into the skin. A telescope is inserted into the kidney and the stone is broken into small pieces using specialised energy sources before being removed.

Recovery

Most patients stay in hospital for 1–2 nights. You may have a temporary ureteric stent or kidney drainage tube following surgery. Most people return to normal daily activities within 2–4 weeks.

Benefits

• Highest stone clearance rate for large and complex kidney stones

• Often removes all stones in a single procedure with less need for multiple operations

• Minimally invasive option with quick recovery

Risks

• Bleeding (occasionally requiring transfusion or procedures to control)

• Infection

• Injury to the kidney or nearby organs

• Need for additional procedures if stone fragments remain