History of PNL

  • Peter AlkenEmail author


Percutaneous nephrolithotomy (PNL) has continuously evolved in several aspects. Early anecdotal reports used cystoscopes through tracts originally operatively established for other purposes. Percutaneous nephrostomy was one step towards a systemic application. Stone extraction under fluoroscopic control was limited by the stone size. Endoscopy combined with lithotripsy using ultrasound or mechanical impactors offered a broad indication not limited by size or composition of stones in the late 1970s. Flexible nephroscopes reduced the need for multiple tracts to remove large stones. Size reduction of nephroscopes allowed single-step- or no-dilation access. Combined with the thin fibers of laser lithotripters they effectively competed with ureterorenoscopy. Small tracts lead to an increased use of no-nephrostomy and no-tube procedures. This continuous development is the basis for the ongoing application of PNL since 40 years.


Percutaneous Nephrolithotomy PNL PCNL History Urolithiasis Nephroscope Lithotripsy Renal Kidney stones 


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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Department of UrologyUniversity Clinic MannheimMannheimGermany

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