Best Hospital for Kidney Stone Treatment by PCNL in Jaipur: Kidney stone disease is a recurrent urological problem that often requires a tailored approach based on stone size, location, and the patient’s clinical history. At the Institute of Urology, Jaipur, our emphasis is on precise diagnosis and a patient-centric treatment plan that ensures effective stone clearance and minimises recurrence. This case demonstrates how a dependent calyceal stone was successfully managed using Percutaneous Nephrolithotomy (PCNL) and how clinical judgement played a crucial role in deciding the right treatment modality.
Case Presentation
A 30-year-old female presented to our hospital with complaints of left-sided flank pain on and off for the last few weeks. She had a past history of bilateral laser lithotripsy in 2017 performed at our hospital, which was successful, and she had remained symptom-free for several years.
Investigations
- Ultrasonography (USG): Revealed an 18–20 mm dependent lower calyceal stone in the left kidney and another small calyceal stone in the right kidney, which was asymptomatic.
- Renal function tests: Serum creatinine was within normal limits, and overall kidney function was preserved.
Given the stone size and location, further treatment planning was done after a detailed consultation with the patient and her family.
Treatment Plan
After thorough discussion, the team decided to proceed with:
- Cystoscopy with Retrograde Pyelography (RGP) to confirm anatomy and access.
- Left PCNL (Percutaneous Nephrolithotomy) for the dependent lower calyceal stone.
- DJ stenting for better post-operative drainage and healing.
Procedure
The procedure was carried out under appropriate anaesthesia. The stone was precisely fragmented using advanced laser technology, ensuring complete clearance without trauma to the surrounding renal tissue. A DJ stent was placed for optimal drainage, and a nephrostomy tube was inserted temporarily, which was removed the following day.
The patient tolerated the procedure well and was discharged the very next day in a stable condition.
Rationale for PCNL over RIRS
In this case, although Retrograde Intrarenal Surgery (RIRS) is generally preferred for stones up to 20 mm, the location of this particular stone in a dependent lower calyx made PCNL the better option for complete clearance. This highlights the customised and patient-centric approach adopted at the Institute of Urology, Jaipur, where Dr. M. Roychowdhury and Dr. Rajan Bansal carefully evaluate every case to ensure optimal results with minimal re-interventions.
Post-operative Care and Follow-Up
The patient was advised a follow-up visit for DJ stent removal after 3–4 weeks. Additionally, because she had a history of recurrent stone formation and bilateral nephrolithiasis, a metabolic workup was recommended. This investigation will help identify the root cause of her stone recurrence, allowing for a targeted preventive strategy to minimise the risk of future stone formation.
Discussion
This case reinforces the importance of individualised treatment planning in urology. While RIRS is an excellent choice for most 10–20 mm stones, dependent calyceal stones often require PCNL for better outcomes. Furthermore, incorporating metabolic evaluation into the treatment pathway can significantly reduce recurrence rates, improving long-term patient quality of life.
Conclusion
The Institute of Urology, Jaipur has performed over tens of thousands successful urological surgeries with consistently excellent outcomes and one of the highest patient satisfaction rates in Rajasthan. With world-class infrastructure, the latest laser technology, and the unmatched expertise of Dr. M. Roychowdhury and Dr. Rajan Bansal, we continue to deliver precise, personalised, and effective urological care under one roof – from consultation and diagnostics to treatment and follow-up.
