Kidney & Bladder Surgery
Percutaneous Nephrolithotomy (PCNL)
A highly effective keyhole surgery for large or complex kidney stones. By creating a direct path to the stone, we can often clear everything in a single session, helping you avoid multiple procedures and get back to your life sooner.
Key takeaways
- A highly effective keyhole surgery for large or complex kidney stones. By creating a direct path to the stone, we can often clear everything in a single session, helping you avoid multiple procedures and get back to your life sooner.
- Specialty: Kidney & Bladder Surgery
Keyhole
Single small incision
General
Usually general anaesthetic
High
Single-op stone-free rate
Treatment Overview
About Percutaneous Nephrolithotomy (PCNL)
PCNL is a specialised keyhole surgery designed for men and women with large or complex kidney stones (usually those over 2cm, or 'staghorn' stones that fill the kidney's drainage system).
Unlike other treatments that use your natural water pipe, PCNL involves making a tiny <1cm incision in your side or back to create a direct 'tunnel' into the kidney. A small telescope is passed through this tunnel, allowing your specialist to break up the stone using lasers or ultrasound and suction the pieces out immediately. For larger stones, this is the most reliable way to maximise the chances that a kidney is completely stone-free in a single operation.
Safety Information
Benefits, Risks & Side Effects
01
Benefits
The biggest benefit of PCNL is its "one-stop" success rate. For very large stones, it can often clear the entire kidney in a single session, whereas other treatments might require two or three separate operations.
Effective: The best way to clear large stone burdens.
Keyhole precision: Avoids the need for a large surgical scar.
Faster Recovery: Compared to old-fashioned 'open' surgery, you’ll have less pain and a much shorter stay in hospital, often going home the same or the following day
02
Risks
While PCNL is an evidence-based procedure following best-practice clinical standards, it is more involved than other stone treatments and carries specific risks. We categorize these by frequency to help you make an informed decision.
🟢 Common (More than 1 in 10 patients)
Infection: Between 1 in 2 and 1 in 10 patients develop a urinary tract infection requiring antibiotics.
Multiple Punctures: Depending on the location of the stones, your surgeon may need to make more than one entry point to clear them.
Future Stones: About 50% (1 in 2) of patients may develop new stones over the next five to 10 years.
🟡 Occasional (Between 1 in 10 and 1 in 50 patients)
Residual Stones: In about 1 in 5 to 1 in 20 cases, fragments may remain that require further surgery or alternative treatment.
Severe Infection (Sepsis): There is a risk of a serious infection requiring an unexpected admission to intensive care.
🔴 Rare (Between 1 in 50 and 1 in 250 patients)
Severe Bleeding: Approximately 1 in 50 to 1 in 100 patients experience bleeding that requires radiological intervention (embolization) to stop, or more rarely removal of the kidney
Organ Injury: There is a rare risk (1 in 100) of accidental injury to nearby organs such as the lung, bowel, liver, or spleen.
Failed Access: Occasionally, it may not be possible to gain satisfactory access to the kidney, necessitating a different surgical approach.
General Medical Issues: Rare complications related to anesthesia or the heart, such as blood clots or chest infections.
03
Side Effects
To help you prepare for your recovery, we use the following traffic light system to outline common after-effects. Many of these are self-limiting or temporary reactions that settle as your kidney and the incision site heal.
🟢 Common (More than 1 in 10 patients)
Mild Bleeding: It is normal to see blood in your urine (and potentially in your nephrostomy tube) for a week or two after surgery.
Soreness and Aching: You will likely feel a dull ache in your kidney area and some soreness around the small incision in your back.
Urine Leakage: After your drainage tube (nephrostomy) is removed, it is common to notice a small amount of urine leaking from the site for 24 to 48 hours.
Bladder Catheter: Most patients will have a temporary drainage tube in their bladder during their hospital stay.
What We Treat
How Percutaneous Nephrolithotomy (PCNL) Can Help You
This treatment is effective for a wide range of health needs. Select a condition below to learn more about how we can support your recovery and improve your daily well-being.
Patient Journey
What to Expect
A step-by-step guide through your Percutaneous Nephrolithotomy (PCNL) journey—from preparation and what happens during the procedure to recovery and aftercare.
01/ 03
Before Procedure
To prepare for a successful surgery, you will have a high-definition CT scan to map the stone's exact shape.
Health Check: You’ll have a pre-operative assessment to check your kidney function and general health.
Infection Check: You must have a clear urine test one week before surgery. You may be asked to take antibiotic tablets prior to surgery.
Medication: It is vital to tell your surgeon about any blood-thinning medication (like Warfarin or Aspirin), as you will need to stop these for a few days.
Fasting: You must not eat or drink (nil by mouth) for 6 hours before your operation. You may be allowed to drink clear fluids like water up until closer to your surgery, but please follow the instructions given at pre-assessment.
02/ 03
During Procedure
The surgery is performed while you are asleep (general anaesthetic) and usually takes 2 to 3 hours.
You are positioned safely on the operating table.
Using X-ray or ultrasound, the specialist creates a <1cm path into the kidney.
The stone is broken into pieces and vacuumed out.
A stent (a plastic tube which sits between the kidney and bladder is usually placed after surgery to let the kidney heal. Occasionally, temporary drainage tube (nephrostomy) may be placed into your back to let the kidney rest and heal.
03/ 03
After Procedure
Your operation will usually be done as a day case or you may stay one night in hospital.
Clearance Check: You will have a scan done usually 4-6 weeks after surgery to see if all of the stone have been removed
Stent Removal: Your stent is usually removed two weeks after surgery, by flexible cystoscopy in the clinic. This may cause pain and irritation until it is removed, as well as blood in the urine and the need to pee more often.
Hydration: Once home, you must drink 2.5 to 3 litres of water a day to keep your system flushed.
Rest: Avoid heavy lifting (anything heavier than a kettle) or strenuous exercise for about 4 weeks.
Specialists
Specialists for Percutaneous Nephrolithotomy (PCNL)
Leading experts for this treatment. View profiles to see clinical backgrounds and current availability.
Our Commitment
Care you can trust
Every treatment is delivered to the same standard: senior consultants, a personalised plan, and the safety of an accredited private hospital behind you.
Consultant-Led Excellence
Receive evidence-based treatments delivered by senior NHS consultants in a professional, specialist setting.
Personalised Care Plans
Your consultant will design a bespoke treatment plan tailored to your specific health goals and lifestyle.
Hospital-Grade Safety
We operate within leading private hospitals, adhering to strict CQC safety and technology standards.
A Heritage of Trust
Our partners bring decades of NHS and private experience, successfully managing thousands of patient cases.
Trusted Resources
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Patient Guidance
Frequently Asked Questions
Common questions about this treatment and what to expect.
2 questions
The incision for PCNL is very small, typically only about 1cm to 1.5cm in length (roughly the width of a fingernail). While there will be a small mark initially, it usually heals very well and fades into a faint, barely noticeable scar over a few months. Most of the 'work' is done internally through this tiny keyhole.
Reviewed 2 Mar 2026
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A staghorn stone is a large stone that has grown to fill the entire 'pelvis' and 'calyces' (the collecting branches) of the kidney, looking a bit like a deer's antler. These stones are too large and hard to be broken effectively from the outside. PCNL is the only treatment that allows a surgeon to directly access the entire stone and physically remove all the pieces through a single small tunnel.
Reviewed 2 Mar 2026
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