Paediatric PCNL for Kidney Stones: A Parent’s Guide from AINU Hospital

Asian Institute of Nephrology and Urology | April 17, 2025

Living busy lives, following unbalanced lifestyles, and being surrounded by polluted environments and consistent irritants has led children to develop ailments like kidney stones, which were unheard of (in children) a few years ago. Where some small stones are passed naturally, bigger ones may require surgical treatment such as PCNL surgery for children. This is a minimally invasive surgical procedure that helps eliminate stones from children's kidneys and is highly effective.

What Is PCNL Surgery for Children?

Percutaneous nephrolithotomy surgery, abbreviated as PCNL, is a procedure used for removal of large kidney stones. It is a minimally invasive treatment option and is suitable for children also. The procedure involves making a tiny cut or incision on the back. Through this cut, a narrow tube is inserted into the kidney, and with the help of a small endoscope and energy source like laser , the kidney stones are broken and extracted. Since the incision made is very small, post-procedure recovery is relatively faster, with minimal pain and scarring afterwards. In fact, the time to recover fully is also minimized.

The procedure is used for treating large kidney stone burden in children because, in these situtaions, medications typically prove to be unhelpful. However, for smaller and uncomplicated stones, conservative and non-surgical treatments are still used. The use of paediatric PCNL for kidney stones also comes with a high stone free rate, going up to 95% for children, enabling them to make quick recoveries and return back to their normal lives in roughly a week.

Apart from PCNL, there are many other treatment options of a non-surgical nature to address kidney stone removal in kids. These include methods like:

• Conservative management systems, which include increasing the intake of fluids to flush out the stones, changing the diet by minimizing intake of salt and oxalate-rich foods, and prescribing medicines that help regulate pain and enable smooth passing of the stones.
• Another method used to treat kidney stones in children includes ESWL, or extracorporeal shock wave therapy, which sends shock waves into the kidney for breaking down the stone into tiny fragments that can be passed naturally. However, this treatment path can require multiple sittings.

However, it must be remembered that these pediatric kidney stone treatment options are only suitable for smaller stones, while PCNL is suitable for treating larger kidney stones.

How PCNL Surgery for Children Works

The PNCL surgery is a relatively simple treatment procedure that is performed in a step-by-step manner. In this section we will understand these steps, which help ensure that the treatment goes on smoothly, with minimal discomfort to the child and maximum potential for success.

Pre-Surgery Assessments

Before the surgery is performed or even recommended, the doctors will assess the child’s condition to chart the ideal path of treatment. Pre-assessment tests, including imaging tests like CT scans, ultrasounds, and x-rays, are performed to find the position of the stones. Apart from these, blood testing and urine tests are performed for analysing kidney function and the potential for developing an infection. The doctors then share their findings with the family, suggesting the right course of treatment, and setting a schedule for the surgery where needed.

Performing Surgery

The minimally invasive kidney stone surgery for children process involves creating a small, roughly 1 cm incision on the back. Through this incision, a small endoscope is passed into the kidney by means of a thin tube. This endoscope offers visibility of the stone while laser or ultrasound energy is used in a targeted manner to break down the large stone into small pieces. These small pieces of the stone are carefully removed from the kidney. Thereafter, the endoscope and tubes are removed, and the incision is sutured with a single suture . A small ureteral stent,may sometimes be placed during the surgery for enabling the urine and small residual stone fragments to pass into bladder without hindrance.

Post-Surgery Recovery

After the procedure is completed, based upon the individual case scenarios, the doctors may recommend staying admitted to monitor recovery and healing. Post this period of recovery, the child will be discharged with the advice that they may experience some mild pain and discomfort for seven to ten days after which they can gradually return back to their normal activities.

Signs to Notice in Children

Parents with young children need to pay attention to some warning signs of kidney stones, which can help in ensuring the right care is provided at the right time. If your child experiences the following symptoms, consult a pediatric urologist at the earliest:

• Persistent and recurrent pain in the abdominal area, sides, and back.
• Presence of blood in urine
• Recurring UTIs
• Pain during urination

If your child complains about any of these symptoms, the best course of action is to get them tested by a pediatric urologist.

The Best Hospital for Pediatric PCNL

For parents, finding the best urology hospital for pediatric kidney stone treatment isof utmost priority to ensure their child gets the best care to take care of kidney stones. This is where we at AINU hospital come forward as the answer. With AINU hospital kidney stone treatment, your child is in safe hands as our paediatric urologists emphasize precision and empathy for a hassle-free treatment. Our team of pediatric urology specialists in India offers every child the chance to live their life to the fullest by carefully treating kidney stones with the utmost care. With extensive experience and a track record of successful procedures, our experts know how to best handle even the most sensitive of cases, ensuring your child experiences minimal pain and recovers quickly.

Conclusion

Kidney stones are an increasingly common concern among children due to a number of factors such as unbalanced and improper lifestyle habits, poor diets and inadequate fluid intake, among others. To treat this issue, timely intervention is essential by the right professionals, who can assess the severity of the kidney stones and recommend the right course of action to treat it. While in most cases the stone can pass out naturally, in cases where it is large, surgical procedures like PCNL may be needed.