PCNL (Percutaneous Nephrolithotomy) In Singapore
Percutaneous Nephrolithotomy (PCNL) is a minimally invasive procedure used to remove large or complex kidney stones through a small incision in the back. It is recommended when stones are too large or dense to be treated with shock wave therapy or other non-invasive techniques.
Medically reviewed by Dr Ho Siew Hong
Senior Consultant Urologist
MBBS (NUS), FRCS (Edinburgh, Glasgow), FAMS (Urology), Singapore Board Certified Urologist
PCNL involves making a small incision of about 1cm in the patient’s back to insert a nephroscope directly into the kidney. The stone is then broken into smaller pieces using ultrasonic or laser energy and removed through the tract. It can remove very large stones and complex staghorn stones.
- Kidney stones larger than 2 cm
- Staghorn calculi (branched stones)
- Stones resistant to ESWL or RIRS
- Stones causing obstruction or recurrent infections
- High success rate for large or complex stones
- Minimally invasive and had completely replaced open surgery
- Direct access allows complete stone clearance
- Effective even for staghorn or infected stones
- General anaesthesia is given
- A small incision is made in the flank or back
- A tract is created directly into the kidney under imaging guidance
- A nephroscope is inserted to visualise the stone
- Stone is fragmented by laser or ultrasonic energy and removed by suction
- A nephrostomy tube or internal stent may be left for drainage
- Hospital stay of 2–3 days
- Drainage tube (nephrostomy) usually removed in 1–2 days
- Resume normal activities in 1–2 weeks
- Follow-up imaging after 4–6 weeks to confirm clearance
- Hydration and stone prevention advice provided
- Bleeding from the access site
- Injury to surrounding organs (rare)
- Infection or sepsis
- Urine leakage or prolonged drainage
Get Relief from Kidney Stone Pain
If you’ve been diagnosed with large or complex kidney stones, consult Dr Ho Siew Hong for expert evaluation. Early treatment helps prevent complications and promotes faster recovery.
Frequently Asked Questions
Discomfort is usually well-managed with medication. Recovery is much faster than open surgery.
Yes, but it is small (about 1–1.5 cm) and usually fades over time.
A typical surgery takes about 1-1.5 hours. Larger and complex stones needing multiple punctures and tracts will take longer and up to 2-3 hours.
Sometimes. Residual stones may need further treatment depending on their size and location.
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