Complications and Management in Percutaneous Nephrolithotomy (PCNL)

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Complications and Management in Percutaneous Nephrolithotomy (PCNL)

  • July 7, 2023


Percutaneous nephrolithotomy (PCNL) is an innovative surgical technique which addresses the challenge of kidney stones removal. It is a minimally invasive approach wherein a small incision on the back is made which grants access to the kidney. It utilizes cutting-edge instruments, advanced technology, skilled surgeons to meticulously fragment and then remove the stones.

PCNL is in general a safe and effective technique but like every other procedure, it carries some risk and complications. Patients need to be aware of these complications so to understand the management strategies better and make informed decisions on their journey of PCNL.

In this article, Aastha Hospital sheds light on the common risks associated with PCNL and addresses their management approaches as advised by the best nephrologist in ludhiana. So, let’s take a look at the below overview:


  • Complication: Bleeding is a common complication of PCNL.
  • Management: In severe cases of bleeding, surgeons closely monitor the vital organs, urine output and blood transfusion. They make use of angiographic embolization or surgical exploration to monitor such cases.



  • Complication: Urinary tract infections (UTIs) and systemic infections are common by-products of PCNL surgery.
  • Management: Surgeons administer preoperative antibiotics based on culture and sensitivity reports which minimize the risk of infections. They also ensure maintenance of sterile techniques during the surgery.


  1. Urinoma:
  • Complication: Urinoma occurs when urine gets collected outside the urinary tract due to leakage.
  • Management: Surgeons closely monitor any signs of urinoma such as swelling, pain and drainage of the urinoma via percutaneous or surgical interventions.


  1. Injury to surrounding organs:
  • Complication: PCNL poses a potential complication of inflicting injury to surrounding structures like blood vessels, bowel or surrounding organs.
  • Management: Surgeons should immediately recognize and repair injuries if they get identified during the surgery. Postoperative imaging can also be used to detect and manage any unrecognized injuries.


  1. Respiratory Risks:
  • Complication: Pneumothorax or hemothorax can occur during the surgery due to injury to lungs or blood vessels.
  • Management: Surgeons place a chest tube and closely monitor the respiratory function with apt oxygen support.


  1. Residual Stones:
  • Complication: There is risk of incomplete stone clearance which result in residual stones.
  • Management: Surgeons use procedures of repeat PCNL, shockwave lithotripsy (SWL) or flexible ureteroscopy (URS) to clear the residual stones.


  1. Postoperative Pain:
  • Complication: Post- operative pain and discomfort are very common after PCNL surgery.
  • Management: Surgeons administer appropriate analgesics and pain management techniques. They facilitate supply of adequate fluids to promote stone fragments flushing.


PCNL is as effective procedure for kidney stone removal but at the same time, recognition and management of the potential complications associated with it is important. Patients and healthcare providers should openly communicate to address any concerns and work together to achieve successful results of the procedure.

For effective pcnl surgery in ludhiana, contact Aastha Hospital and take a step forward in restoring your kidney health today.