Percutaneous Nephrolithotomy (PCNL) in India

Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure used to remove large or complex kidney stones that cannot be treated with non-invasive methods like ESWL. The procedure involves creating a small tract through the skin into the kidney to directly access and remove stones.

India provides advanced urology care, experienced surgeons, modern imaging, and comprehensive post-operative management for PCNL patients.

Indications for PCNL

  • Large kidney stones (>2 cm)

  • Complex or staghorn calculi

  • Stones resistant to ESWL or other non-invasive treatments

  • Stones causing recurrent urinary tract infections (UTIs) or obstruction

  • Multiple or recurrent stones

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Symptoms Addressed

  • Severe flank or abdominal pain

  • Blood in urine (hematuria)

  • Frequent urinary tract infections

  • Nausea, vomiting, or fever in case of infection

  • Kidney damage due to obstruction


Procedure Overview

  1. Pre-operative Assessment

    • Blood tests, renal function tests, imaging (CT, X-ray, ultrasound)

    • Evaluation for anesthesia and overall fitness

  2. Surgical Procedure

    • Performed under general anesthesia

    • Small incision (~1 cm) is made in the back

    • A tract is created into the kidney using imaging guidance

    • Stones are fragmented and removed using specialized instruments

    • A nephrostomy tube may be temporarily placed for drainage

  3. Post-operative Care

    • Hospital stay: 2–4 days

    • Pain management, fluid monitoring, and wound care

    • Gradual return to normal diet and activity

    • Follow-up imaging to ensure complete stone clearance


Benefits of PCNL

  • Minimally invasive with small incision

  • Effective for large and complex kidney stones

  • High stone clearance rates compared to ESWL

  • Reduced recovery time compared to open surgery

  • Can be repeated for recurrent stones


PCNL Cost in India

Table 1: Average PCNL Cost in India

Procedure TypeMinimum Cost (INR)Maximum Cost (INR)Approx. USD Range
PCNL Procedure₹1,50,000₹3,50,000$1,810 – $4,220
Pre-operative Imaging & Tests₹20,000₹50,000$240 – $600
Post-operative Care & Medications₹30,000₹80,000$360 – $960

Factors Affecting Cost

  1. Size and complexity of stones – Larger or multiple stones increase cost

  2. Hospital facilities and city – Advanced urology centers may charge more

  3. Patient health – Comorbidities or complications may require extended care

  4. Procedure type – Standard PCNL vs mini-PCNL or supine PCNL

  5. Follow-up care – Imaging, medications, and nephrostomy management


Who Should Consider PCNL?

  • Patients with large, complex, or recurrent kidney stones

  • Individuals whose stones cannot be treated with ESWL or ureteroscopy

  • Patients referred by urologists or nephrologists

  • Suitable for adults and selected pediatric patients depending on stone size

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