Percutaneous nephrolithotripsy

Diagram of PCNL

Percutaneous stone surgery is usually used for larger stones. A small hollow tube is placed directly through a patient’s back into the kidney through which larger instruments can then be used to fragment and extract the stone(s). Although this approach typically requires a hospital stay and is more invasive than ureteroscopy or extracorporeal shockwave lithotripsy, it is often the most effective method for treating  large stones quickly and completely. For more information on comparing the surgical options for kidney stones, see our comparison chart.

Percutaneous stone surgery may also be indicated in certain situations where the ureter below a  kidney is obstructed, such as in ureteropelvic junction obstructions, where a ureteroscope cannot be advanced from below.

Fast facts about percutaneous nephrolithotripsy:

  • Typical operative time: 1-2 hours
  • Usual hospital stay: 1-2 days
  • Average number of days before going back to work: about one week
  • Average number of days before feeling back to normal: about two weeks

PCNL instruments photo

A photograph showing a nephroscope used for percutaneous nephrolithotripsy. The gray tube around the instrument is the sheath placed temporarily into a kidney to allow access. A pen is shown for size comparison.



Video of percutaneous nephrolithotripsy procedure.



Video of percutaneous nephrolithotripsy procedure of a soft matrix stone. This type of stone is rare and primarily composed of  soft tissue elements. It is usually associated with infection.

54 Responses to Percutaneous nephrolithotripsy

  1. Trilochan singh says:

    I just gone through this treatment for multiple stones in left kidney with one more than 24mm large from RG Stone Clinic ,pitam pura Delhi India i got a great experience with very skilled Doctors with great care and hospatilaty.Those Doctors were like God to me.THANKS

  2. r. pecego says:

    I went through this surgery two months ago for a1.8 cm non obstructing staggers appetite stone … according to ct scans and many pre operation tests performed by a very busy urology group. The rude and hurried radiology team placed the tube that leads to the kidney at the wrong angle for the surgeon to remove the stone which resulted in a longer operating time and an unsuccessfully attempt at complete removal. Generally the tube is left in over night to see what stones remain and the doctor does a do over. Not for me…just a big cover up of errors and 50,000 dollars later … see you in four months and we order up … beware!!!

    • diane jones says:

      oh Wow, same thing happened to me. Had to go back to hospital two or three times because of leakage from the tube. The pain was incredible. Then when it came time for Dr to put it out, he did it in his office without any anesthesia. I thought someone heard my screams in another country. It was horrendous. He couldn’t do it on the first yang, but the second one it came out.

  3. Robert Hill says:

    I here you. Waking up after ureteroscopy, and having to pee that first time, is like pissing the burning lakes of Hades through your penis. It sucks.

    I’ve got a 9mm stone in my lower right ureter. Doc was unable to get it with ureteroscopy the first time. Wants to try it a second time, end of the month. I am totally dreading this, due to the burning lakes in my penis.

    I have a feeling he’s going to end up going in and surgically removing it eventually.

  4. Ernest Leith says:

    Just went through surgery last night for basic ureteroscopy and (I’ve begged a decade ago to remove the smaller stones, bUT they refused cuz they “may or may not pass”) now I find out after the surgery I have big stones that could not be blasted. I’m so over this stent burning everytime a pee! It’s like pissing lava or razors. Worst part I’d waking up and not falling back asleep due to the shock and pain the pee sends through your body. I can’t imagine a cath. I wish I was born without pain receptors just so I don’t feel pain.

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