The current status of percutaneous nephrolithotomy in the management of kidney stones

Large kidney stones (>2 cm) is a common problem affecting all population groups across the globe and may result in significant complications if left untreated. The treatment for this condition has evolved dramatically over the past seven decades with the advent of minimally invasive treatment options. At the forefront of this paradigm shift is the development of percutaneous nephrolithotomy (PCNL). This has resulted in shorter hospital stays, reduced postoperative pain, and quicker convalescence compared with the previous criterion standard of open stone surgery. PCNL is only one of the many minimally invasive treatment options available for this condition, but remains the most efficient in all patient groups. However, it continues to be one of the more challenging urological procedures, which if not performed well, can be associated with significant complications. Refinements in techniques, improvement in equipment and increasing clinical experience have led to improved stone free rates being achieved with acceptably low patient morbidity. In this article, authors review the technical aspects, outcomes, and current role of PCNL in the treatment of large kidney stones.