Skolarikos et al listed indications for percutaneous nephrolithotomy (PNL) may be appropriate for the management of a patient with renal stones. The authors are from the University of Athens and AMC University Hospital in Amsterdam.


Patient selection: kidney stone


Indications for percutaneous nephrolithotomy:

(1) large stone (typically those >= 2 cm in diameter) or high stone burden

(2) hard stones (struvite, other)

(3) lower calyceal stone

(4) stones causing obstruction with hydronephrosis

(5) stones associated with infection

(6) patient and/or physician preference (for certainty of clearance, etc)

(7) failure of extracorporal shock wave lithotripsy (ESWL) and/or ureteroscopy

(8) contraindications to ESWL

(9) anatomic variation (horseshoe, malrotated, pelvic)

(10) transplanted kidney


Percutaneous nephrolithotomy can be used in children with one or more of the above indications.


Problems with percutaneous nephrolithotomy:

(1) higher rate of complications


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