Complications of percutaneous nephrostolithotomy

Percutaneous nephrostolithotomy (PNL) was first described by Fernstrom and Johannson in 1976(1) and has become accepted as a highly effective and relatively safe method for treating renal stones which are not amenable to shock wave lithotripsy. Accepted indications for PNL include treatment of staghorn calculi, large renal stone burdens, lower pole calculi, cystine calculi and calculi in kidneys with abnormal anatomy such as a uretropelvic junction obstruction or a calyceal diverticulum.(2) Decreased morbidity, rapid post-operative recovery and improved patient and physician acceptance have led to virtual replacement of open renal surgery by percutaneous endoscopic surgery for these indications. Despite the decreased morbidity, PNL is associated with its own set of complications, which must be appreciated by the physician and the patient when choosing it as a method of treatment.