Renal calculi. Percutaneous management.

Percutaneous nephrolithotomy has established indications and is performed with high success and minimal morbidity. Patients who have large or hard stones or stones associated with urinary obstruction are candidates for a percutaneous procedure. When the certainty of the final result is important, the patient should have a PNL. In general, the best treatment for SWL failure is not more SWL; such patients usually should have an endoscopic procedure.