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Abstract Percutaneous nephrolithotomy (PCNL) is a less invasive endourologic procedure for treatment of large renal stones introduced by Fernström and Johansson in 1976. Currently, PCNL is the treatment of choice for kidney stones greater than 2 cm according to both EAU &AUA guidelines. However, PCNL has potentially higher rates of mild to moderate complications. The idea of using ultrasound-guided access in PCNL may allow better imaging of the kidney, stones and adjacent organs: pleura, spleen, liver, colon beside decrease radiation hazards. PCNL stone free rate is 80-90% for renal calculi and 86% for proximal ureteric calculi. The success rate of PCNL is independent of stone burden, whereas the success rate of ESWL and ureteroscopy decline as stone burden increases. Obese patients have a lower stone free rate with PCNL. |