• Sarwar Noori Mahmood Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.



Percutaneous nephrolithotomy, renal calculi, Complication



Percutaneous nephrolithotomy (PCNL) is generally accepted to be a minimal invasive technique with low complication rates. In the current study we reviewed our initial experience with percutaneous nephrolithotomy.

Patients and Methods

A prospective study of 125 patients with mean age of (34.65) years, underwent PCNL in our center from April 2009 to November 2010. PCNL done in prone position by a single experienced faculty urologists under general or spinal anesthesia under fluoroscopic guidance. The kidney was punctured via a lower pole calyx whenever possible. The demographic data, stone parameters, PCNL complications and stone-free rate were evaluated.


One hundred twenty five patients, underwent percutaneous nephrolithotomy , 85 male and 40 female, with a mean (range) age of 34.65 (3-83) years, and a mean (range) stone size of 39,6 mm (10-80) mm. Stone-free rate after PCNL monotherapy was 81.6%, which increased to 88% with clinically insignificant small residual fragments ≤4 mm. Overall complication rate was observed in twenty six patients (20.8%). Majority were minor complications, with the most common observations of transient fever (11.2%), need for blood transfusion (5.6%), pelvic and calyceal perforations were 4%, and all managed conservatively. No death, urosepsis, nor injuries to adjacent organs were recorded.


Our data demonstrate that PCNL is a safe and effective technique. Most of the intraoperative incidents or complications are minor and easy to solve. However, an adequate training is imperative in order to reduce the associated morbidity.


Khan S, Toori LA, Anwer K. The efficacy of percutaneous nephrolithotomy in renal and upper ureteric calculi. Pakistan Journal of Medical Sciences. (2005); 44(2):89-91.

Rassweller JJ, Renner C, Eisenberger F. The management of complex renal stones. British Journal of Urology. (2000); 86(8):919-928. DOI:

Thüroff JW, Gillitzer R. Percutaneous Endourology & Ureterorenoscopy : Smith’s General Urology. 7th ed. New York: Mcgraw hill; 2008. P. 114-132.

Dimopoulous C, Gialias A, Likourinas M, Androutsos A, Kostakopoulos A. Hippo crates: founder and pioneer of urology. British Journal of Urology .1980; 52(2): 73-4. DOI:

Lee WJ, Smith AD, Cubelli V, Badlani GH, Lewin B, Vernace F, et al. Complications of percutaneous nephrolithotomy. AJR American journal of roentgenology. 1987; 148(1):177-80. DOI:

Jones DJ, Russell GL, Kellett MJ, Wickham JE. The changing practice of percutaneous stone surgery. Review of 1000 cases 1981-1988. British journal of urology. 1990; 66(1):1-5. DOI:

de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, et al. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. Journal of endourology / Endourological Society. 2011; 25(1):11-7. DOI:

Turna B, Nazli O, Demiryoguran S, Mammadov R, Cal C. Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology. (2007); 69(4): 603-7. DOI:

Assimos DG Marshall L, Stoller MD, Smith AD. Complications of Stone Removal. Smith’s Textbook of Endourology. First edition. St. Louis, Missouri, USA: Quality Medical Publishing; (1996):298-308.

Mantu Gupta, Michael C. Ost, Jay B. Shah, Elspeth M. McDougall, and Arthur D. Smith .Percutaneous management of the upper urinary tract. Campbell-Walsh urology. 9th ed. Philadelphia: Saunders; 2008.

Tefekli A , Ali Karadag M, Tepeler K, Sari H , Berberoglu Y, Baykal M, et al. Classification of Percutaneous Nephrolithotomy Complications Using the Modified Clavien Grading System: Looking for a Standard . European urology. 2008; 53(1): 184–190. DOI:

Zimmermanns V, Liske P, Lahme S. Minimal invasive PCNL in the treatment of nephrolithiasis –analysis of efficiency and complications after 335 consecutive patients. European Urology Supplements. 2009; 8(4): 326. DOI:

Ko R, Soucy F, Denstedt JD, Razvi H. Percutaneous nephrolithotomy made easier: A practical guide, tips and tricks. BJU international. 2008; 101(5): 539-9. DOI:

Chew BH, Chiu RY, Hamidizadeh R, Wright I, Chan SH, Rowley VA, et al. Success and complication rates in 729 percutaneous nephrolithotomy at a single center. The journal of urology. 2009; 181(4). DOI:

El-Nahas AR, Shokeir AA, El-Assmy AM, Mohsen T, Shoma AM, Eraky I, et al. Post-percutaneous nephrolithotomy extensive hemorrhage: a study of risk factors. The Journal of urology. 2007; 177(2):576-9. DOI:

Shah HN, Kausik VB, Hegde SS, Shah JN, Bansal MB. Tubeless percutaneous nephrolithotomy: a prospective feasibility study and review of previous reports. British journal of urology International. 2005; 96(6):879-83. DOI:

Roth RA, Beckmann CF. Complications of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. Urologic Clinics of North America. 1988; 15(2):155-166. DOI:

Falahatkar S, Khosropanah I, Roshani A, Neiroomand H, Nikpour S, Nadjafi-Semnani M, et al. Tubeless percutaneous nephrolithotomy for staghorn stones. Journal of endourology / Endourological Society. 2008; 22(7):1447-51. DOI:

Davidoff R, Bellman GC. Influence of technique of percutaneous tract creation on incidence of renal hemorrhage. The Journal of urology. 1997;157(4):1229-31. DOI:

Deane LA, Clayman RV. Advances in percutaneous nephrostolithotomy. The Urologic clinics of North America. 2007; 34(3):383-95. DOI:

Rana AM, Mithani S. Tubeless percutaneous nephrolithotomy: call of the day. Journal of endourology / Endourological Society. 2007; 21(2):169-72. DOI:

Liatsikos EN, Kapoor R, Lee B, Jabbour M, Barbalias G, Smith AD. ‘‘Angular Percutaneous Renal Access’’. Multiple Tracts Through A Single Incision for Staghorn Calculous Treatment in a Single Session. European Urology. 2005; 48: 832–837. DOI:

Payne SR, Ford TF, Wickham JE. Endoscopic management of upper urinary tract stones. The British journal of surgery. 1985; 72(10):822-4. DOI:

Steele D, Marshall V. Percutaneous nephrolithotomy in the supine position: a neglected approach? Journal of endourology / Endourological Society. 2007; 21(12):1433-7. DOI:

Giusti G, Piccinelli A, Taverna G, Benetti A, Pasini L, Corinti M, et al. Miniperc? No, thank you! European urology. 2007; 51(3):810-4. DOI:

Knoll T, Heger K, Haecker A, Osman M, Michel MS, Kohrmann KU, et al. Percutaneous nephrolithotomy Experience with 348 cases. European Urology Supplements. 2004; 3(2): 13. DOI:

Li MK, Wong MY, Toh KL, Ho GH, Foo KT. Percutaneous nephrolithotomy--results and clinical experience. Annals of the Academy of Medicine, Singapore. 1996; 25(5):683-6.

Lahme S, Bichler KH, Strohmaier WL, Gotz T. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. European urology. 2001; 40(6):619-24. DOI:

Reddy PK, Hulbert JC, Lange PH, Clayman RV, Marcuzzi A, Lapointe S, et al. Percutaneous removal of renal and ureteral calculi: experience with 400 cases. The Journal of urology. 1985; 134(4):662-5. DOI:

Young AT, Hunter DW, Castaneda-Zuniga WR, Hulbert JC, Lange P, Reddy P, et al. Percutaneous extraction of urinary calculi: Use of the intercostal approach. Radiology. 1985; 154(3):633-8. DOI:

Patterson DE, Segura JW, LeRoy AJ, Benson RC, Jr., May G. The etiology and treatment of delayed bleeding following percutaneous lithotripsy. The Journal of urology. 1985; 133(3):447-51. DOI:

Stoller ML, Wolf JS, Jr., St Lezin MA. Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. The Journal of urology. 1994; 152(6 Pt 1):1977-81. DOI:

Walsh PC, Retnik AB, Vaughan E. Campbell’s Urology. 8th ed. Philadelphia: WB Saunders; 2002. P. 3320–3360.

Segura JW, Patterson DE, LeRoy AJ, Williams HJ, Jr., Barrett DM, Benson RC, Jr., et al. Percutaneous removal of kidney stones: review of 1,000 cases. The Journal of urology. 1985; 134(6):1077-81. DOI:

Jemni M, Bacha K, Ben Hassine L, Karray MS, Ayed M. [Results of the treatment of renal lithiasis by percutaneous nephrolithotomy: apropos of 115 cases]. Progres en urologie : journal de l’Association francaise d’urologie et de la Societe francaise d’urologie. 1999; 9(1):52-60.

Sahin A, Atsu N, Erdem E, Oner S, Bilen C, Bakkaloglu M, et al. Percutaneous nephrolithotomy in patients aged 60 years or older. Journal of endourology / Endourological Society. 2001; 15(5):489-91. DOI:

Hossain M, Ullah AT, Regmi S, Rahman H, Kibria SA. Safety and efficacy of the supracostal access for percutaneous nephrolithotomy: Our initial experience. Bangladesh Medical Research Council Bulletin. 2011; 37(1): 34-38. DOI:

Mousavi-Bahar SH, Mehrabi S, Moslemi MK. Percutaneous nephrolithotomy complications in 671 consecutive patients: a single-center experience. Urology journal. 2011; 8(4):271-6.

Corbel L, Guille F, Cipolla B, Staerman F, Leveque JM, Lobel B. [Percutaneous surgery for lithiasis: results and perspectives. Apropos of 390 operations]. Progres en urologie : journal de l’Association francaise d’urologie et de la Societe francaise d’urologie. 1993; 3(4):658-65.






How to Cite

Mahmood S. PERCUTANEOUS NEPHROLITHOTOMY: OUR INITIAL EXPERIENCE WITH 125 CASES. JSMC [Internet]. 2016 Dec. 1 [cited 2024 Jul. 19];6(2):85-90. Available from:

Similar Articles

1-10 of 65

You may also start an advanced similarity search for this article.