Advanced Treatment for Large and Complex Stones
At Fore River Urology’s Kidney Stone Center, we offer Percutaneous Nephrolithotomy (PCNL) — a minimally invasive yet highly effective procedure for treating large or complex kidney stones that cannot be managed with other treatments.
PCNL is more invasive than shockwave lithotripsy (ESWL) or ureteroscopy, but it remains the gold standard for certain situations where precision and complete stone removal are critical.
What Is PCNL?
Percutaneous Nephrolithotomy is a surgical procedure in which a small incision is made in the back to allow direct access to the kidney. Using a specialized scope and instruments, your urologist can remove or break up stones that are too large or too dense for other approaches.
This procedure is typically recommended for:
- Staghorn or large renal stones
- Stones greater than 2 cm
- Stones resistant to fragmentation with ESWL
- Complex or multiple stones in difficult-to-reach areas
Customized Stone Care at Fore River Urology
Our urologists have extensive experience in PCNL and work closely with patients to customize the procedure based on:
- Stone size and location
- Kidney anatomy
- Overall health and comorbidities
We also offer advanced PCNL techniques that improve safety, reduce pain, and shorten recovery time.
Advanced PCNL Techniques We Offer
Mini-PCNL
In select patients, a Mini-PCNL can be performed using a smaller access sheath and instruments. This version often allows for outpatient treatment and is associated with:
- Less bleeding
- Shorter recovery
- Lower complication rates
Tubeless PCNL
In some cases, a nephrostomy tube (a drainage tube from the kidney to an external bag) is not required at the end of the procedure. This is known as Tubeless PCNL, which can:
- Reduce post-op pain
- Improve patient comfort
- Promote quicker recovery
Most patients still require a temporary ureteral stent, which is typically removed in 7–14 days.
Supine PCNL
Traditionally, PCNL is performed with the patient lying face down (prone position), but select patients may be candidates for supine PCNL (lying on the back), which offers potential benefits including:
- Improved anesthesia safety
- Easier access for the surgical team
- Enhanced drainage of stone fragments and urine
Advantages of PCNL
- High success rate for large or complex stones
- Minimally invasive compared to open surgery
- Short hospital stay (usually 1 night)
- Fewer incisions and faster recovery than historical approaches
Risks and Considerations
As with any surgical procedure, PCNL carries potential risks, including:
- Bleeding (1–2%) — may require transfusion or embolization
- Infection
- Urine leak (if the kidney doesn’t heal properly)
- Residual stone fragments
- Need for additional procedures
- Temporary pain or discomfort
Your urologist will thoroughly review your imaging and health history to ensure that PCNL is the safest and most effective approach for your specific situation.
Take the Next Step
If you’ve been diagnosed with a large or complex kidney stone, PCNL may be the most effective way to resolve the problem and prevent recurrence. Our team is here to offer personalized, expert care using the most advanced techniques available in Maine.
Call us today at 207-518-6600
Or request an appointment online
