What is PCNL?

PCNL (Percutaneous Nephrolithotomy) is an advanced minimally invasive surgical procedure used to remove large or complex kidney stones directly from the kidney.
Instead of passing through the urinary tract, the surgeon creates a tiny keyhole incision in the back to access and remove the stones using a nephroscope and laser or ultrasonic energy.

Performed by Dr. Swapnil Gholap, an experienced urologist in Chembur, Mumbai, PCNL offers precise and effective stone removal with minimal pain, reduced recovery time, and excellent success rates.

When is PCNL Recommended?

PCNL is typically advised when:

• Kidney stones are larger than 2 cm in size

• Stones are multiple, complex, or staghorn-shaped

• Stones cannot pass naturally or through other procedures (like RIRS or ESWL)

• There is infection, obstruction, or kidney damage due to stones

• Stones have recurred after previous surgeries

Causes of Kidney Stones

Kidney stones form when mineral salts in urine crystallize and accumulate inside the kidneys. Common causes include:

• Insufficient fluid intake leading to concentrated urine

• High sodium or oxalate diet

• Family history of stones

• Recurrent urinary infections

• Obesity or metabolic disorders

• Certain medications or supplements

Symptoms of Kidney Stones

Patients requiring PCNL may experience:

• Sharp pain in the lower back or sides (flank pain)

• Blood in urine (hematuria)

• Nausea or vomiting due to obstruction

• Burning sensation during urination

• Frequent urinary tract infections

• Fever or chills, if infection is present

The PCNL Procedure

1. Anesthesia & Positioning
The procedure is performed under general anesthesia. The patient is positioned to allow safe and accurate access to the kidney.

2. Keyhole Access
A small incision (about 1 cm) is made in the back to create a narrow tract into the kidney.

3. Stone Visualization & Removal
A nephroscope (thin tube with a camera) is inserted to visualize the stone.
The stone is then broken using laser or ultrasonic energy and fragments are removed through the tract.

4. Drainage Tube Placement
A temporary nephrostomy tube or stent may be placed to help urine drain and aid healing.

5. Recovery
The entire procedure usually takes 1–2 hours, depending on the stone size and number.

Benefits of PCNL

• Effective removal of large and complex stones

• Minimally invasive (tiny incision)

• High success rate

• Shorter hospital stay and faster recovery compared to open surgery

• Minimal bleeding and postoperative pain

• Excellent long-term outcomes with proper care

Recovery & Aftercare

• Hospital stay is usually 2–3 days.

• Mild back discomfort or urine discoloration may occur temporarily.

• Avoid strenuous activity for 1–2 weeks.

• Drink plenty of water to prevent new stone formation.

• Follow-up visit for stent or tube removal within 7–14 days.

• Regular check-ups ensure kidney health and prevent recurrence.

FAQs About PCNL

1. Is PCNL a major surgery?
PCNL is a minimally invasive procedure, not an open surgery. The incision is very small, and recovery is much faster.

2. Is PCNL painful?
No. It is performed under anesthesia. Mild discomfort may occur after surgery, which is easily managed with medication.

3. How long is the recovery period?
Most patients resume normal activities within 7–10 days after discharge.

4. Will I have a visible scar?
Only a tiny scar (about 1 cm) remains at the incision site, which fades over time.

5. Can stones recur after PCNL?
Yes, stones can form again if dietary and lifestyle factors are not managed. Regular follow-ups and preventive care are essential.