Symptoms Addressed

• Severe flank or abdominal pain due to stones

• Blood in urine (hematuria)

• Recurrent urinary tract infections

• Nausea, vomiting, or urinary obstruction

• Reduced kidney function due to stone blockage

Procedure Overview

1. Pre-procedure Evaluation

   • Imaging: CT scan, X-ray, or ultrasound to assess stone size and position

   • Blood and urine tests

   • Anesthesia evaluation

2. During the Procedure

   • Performed under general anesthesia

   • Small incision made in the back to access the kidney

   • A nephroscope is inserted directly into the kidney

   • Stones broken with ultrasound, laser, or pneumatic devices

   • Fragments removed through the nephroscope

3. Post-procedure Care

   • Hospital stay: 2–4 days

   • Nephrostomy tube or ureteral stent may be placed temporarily

   • Pain management, antibiotics, and hydration advised

   • Follow-up imaging to confirm stone clearance

Benefits of PCNL

• High success rate for large or complex stones

• Minimally invasive compared to open surgery

• Direct visualization and removal of stones

• Effective for stones resistant to other methods

• Faster recovery compared to traditional open procedures

Percutaneous Nephrolithotomy (PCNL) Cost in India

Table 1: Average PCNL Cost in India

Factors Affecting Cost

1. Size, type, and number of stones

2. Hospital infrastructure – Metro city super-specialty hospitals may charge more

3. Technology used – Advanced laser or ultrasound stone fragmentation devices

4. Surgeon’s expertise

5. Hospital stay duration – Longer if complications occur

Who Should Consider PCNL?

• Patients with large or multiple kidney stones

• Individuals with staghorn or complex stones

• Patients not responding to ESWL or RIRS

• Those with urinary obstruction or recurrent infections due to stones

• Candidates advised by urologists after diagnostic evaluation