PERCUTANEOUS NEPHROLITHOTOMY (PCNL)
, 2.2.1 DefinitionPercutaneous Nephrolithotomy(PCNL)
Percutaneous Nephrolithotomy(PCNL) is a minimally invasive procedure in the
field of urology which aims to remove kidney stones using percutaneous access to reach
the pelviokaliceal system.
Since the invention of the percutaneous procedure using a needle to decompress
hydronephrosis in 1955 by Willard Goodwin, endourology has developed very rapidly,
especially to treat disorders of the kidneys and upper urinary tract. In the early 1980s the
PCNL procedure was very popular as a therapy for kidney stones, but since the discovery
of Extracorporeal Shock Wave Lithotripsy (ESWL) in the mid 1980s its use has declined.
In subsequent developments, several weaknesses were found in the ESWL procedure, so
that PCNL was once again popular as a treatment for kidney stones with the rapid
advancement of its techniques and equipment.
2.2.2 PCNL indication
Although kidney stones may be asymptomatic, ureteral stones generally cause
colicky pain in most cases. Treatment decisions for upper urinary tract stones are based
on several aspects such as stone composition, stone size, and symptoms. Treatment can
be in the form of conservative therapy or active removal of stones through ESWL, PCNL,
and others. Indications for active removal of kidney stones are as follows:
Stone growing in size (Stone growth)
Patients at high risk of stone formation
Urinary tract obstruction caused by stones
Infection
Symptomatic kidney stones (eg, pain, haematuria)
Stone size > 15 mm
Stone size < 15 mm but conservative therapy is not possible
Patient preference
Comorbidity
Patient's social situation (profession, traveling, etc.)
, 2.2.1 DefinitionPercutaneous Nephrolithotomy(PCNL)
Percutaneous Nephrolithotomy(PCNL) is a minimally invasive procedure in the
field of urology which aims to remove kidney stones using percutaneous access to reach
the pelviokaliceal system.
Since the invention of the percutaneous procedure using a needle to decompress
hydronephrosis in 1955 by Willard Goodwin, endourology has developed very rapidly,
especially to treat disorders of the kidneys and upper urinary tract. In the early 1980s the
PCNL procedure was very popular as a therapy for kidney stones, but since the discovery
of Extracorporeal Shock Wave Lithotripsy (ESWL) in the mid 1980s its use has declined.
In subsequent developments, several weaknesses were found in the ESWL procedure, so
that PCNL was once again popular as a treatment for kidney stones with the rapid
advancement of its techniques and equipment.
2.2.2 PCNL indication
Although kidney stones may be asymptomatic, ureteral stones generally cause
colicky pain in most cases. Treatment decisions for upper urinary tract stones are based
on several aspects such as stone composition, stone size, and symptoms. Treatment can
be in the form of conservative therapy or active removal of stones through ESWL, PCNL,
and others. Indications for active removal of kidney stones are as follows:
Stone growing in size (Stone growth)
Patients at high risk of stone formation
Urinary tract obstruction caused by stones
Infection
Symptomatic kidney stones (eg, pain, haematuria)
Stone size > 15 mm
Stone size < 15 mm but conservative therapy is not possible
Patient preference
Comorbidity
Patient's social situation (profession, traveling, etc.)
