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REVIEW ARTICLE
Year : 2009  |  Volume : 25  |  Issue : 1  |  Page : 4-10

Percutaneous nephrolithotomy: Current concepts


Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, SP, Brazil

Correspondence Address:
Cristiano Mendes Gomes
Av. Enéas de Carvalho Aguiar, 255, 7o. andar, Sala 710F, CEP 05403-000, Sao Paulo, SP
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.44281

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Percutaneous nephrolithotomy (PNL) is the procedure of choice for large renal stones. Since its introduction in 1976, many aspects of the operative technique and the endoscopic equipments have had constant evolution, increasing the success rates of the procedure. We performed a literature search using Entrez Pubmed from January 2000 to July 2007 concerning PNL and many aspects related to all steps of the procedure. We could verify that PNL in supine position has been proved as an acceptable option, but more worldwide experience is necessary. Urologists must be trained to gain their own renal tract access. Minipercutaneous PNL still needs equipments improvements for better results. Tubeless PNL is increasing in popularity and different tract sealants have been studied. Medical prevention is proved to be effective against stone recurrence and should be always used after PNL. Although the evolution of the technique in the last 20 years, urologists must continue to improve their skills and develop new technologies to offer to the patients more and more a safe and effective option to treat large renal stones.


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