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Percutaneous nephrolithotomy, or PCNL, is a procedure to remove kidney stones through a small passage made in the back or side. A surgeon passes a viewing instrument into the kidney to locate the stones. Large stones may be broken into smaller pieces before removal. PCNL is generally considered for large or complex stones or when other treatments have not worked.
read more about percutaneous nephrolithotomy ...A urologist may recommend PCNL for a large kidney stone, a branching staghorn stone, or a stone that other procedures cannot remove. Imaging helps show the stone's size and location. Urine and blood tests help the team check for infection and other concerns before surgery. The treatment choice also depends on kidney anatomy and the patient's health.
The procedure is usually performed under general anesthesia. With imaging guidance, the surgical team creates a small passage from the skin into the kidney. A nephroscope and other instruments pass through that opening to break up and remove the stone. A temporary kidney drainage tube or ureteral stent may be placed afterward.
Patients are monitored in the hospital after PCNL and may stay for one or more days. Some blood in the urine and discomfort around the incision can occur during recovery. The care team provides instructions about activity and the care of any tube or stent. Follow-up imaging may check for remaining stones and confirm that urine drains properly.
Risks include bleeding, infection, and injury to the kidney or nearby organs. Some stone fragments may remain and require another procedure. Fever, chills, heavy bleeding, or worsening pain after surgery require prompt medical attention. The urologist can explain how stone size, infection, and other health factors affect the individual risk.
No. The surgeon reaches the kidney through a small opening in the back or side.
Sometimes. The surgeon may place a nephrostomy tube or ureteral stent to help urine drain during recovery.
PCNL is commonly used for large or complex stones, but complete removal is not guaranteed. Follow-up testing may identify fragments that need further treatment.
Yes. Removing a stone does not prevent a new one from forming, so the care team may analyze the stone and recommend prevention measures.
Percutaneous kidney procedures. MedlinePlus Medical Encyclopedia. https://www.medlineplus.gov/ency/article/007375.htm. Date Accessed September 30, 2026.
Percutaneous nephrolithotomy. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/percutaneous-nephrolithotomy/about/pac-20385051. Date Accessed September 30, 2026.
Percutaneous Nephrolithotomy (PCNL). Penn Medicine. https://www.pennmedicine.org/treatments/percutaneous-nephrolithotomy. Date Accessed September 30, 2026.
Percutaneous Nephrolithotomy (PCNL). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/percutaneous-nephrolithonomy-pcnl. Date Accessed September 30, 2026.
Percutaneous Nephrolithotomy (PCNL): Risks & Results. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/17349-percutaneous-nephrolithotomy. Date Accessed September 30, 2026.