Percutaneous Nephrolithotomy (PNL) is effective in the treatment of large renal calculi, staghorn calculi, multiple renal stones, lower pole renal calculi, cystine calculi, and calculi associated with renal outlet obstruction. In addition, stone composition or moderate obesity does not hamper the efficacy of PNL. For renal stones > 2 cm, ESWL has been shown to be less successful, and more expensive than PNL. Percutaneous nephrolithotomy is very effective in rendering these patients stone free. Patients not rendered stone free during one percutaneous intervention can have further treatment with SWL or with a second nephroscopic session.
A nephrostogram demonstrates a 2.5 cm stone in the lower pole of the left kidney (Figure a). Figure b demonstrates the placement of a nephrostomy tube in the kidney in preparation of the PCNL procedure.
Wolf JS, Clayman RV. Percutaneous nephrostolithotomy: What is its role in 1997? Urol Clin North Am 1997, 24:1:43-58.