Intrarenal pressure in percutaneous nephrolithotomy, from theory to practice

Andres Benitez-Filselcker¹, Felipe Aguila^1,2, Cristobal Avila¹, Tomas Punte^1,3, Jaime Barahona⁴, Fernando Marchant^1,2,*
1Departamento de Urologia, Hospital Clinico Universidad de Chile, Carlos Lorca Tobar 999, Santiago, Chile
2 Servicio de Urologia, Clínica Las Condes, Santiago, Chile
3 Servicio de Urologia, Hospital Padre Hurtado, Santiago, Chile
4 Servicio de Urologia, Hospital San José, Santiago, Chile
* Corresponding Author: Fernando Marchant. Email: email
(This article belongs to the Special Issue: Advances in Endoscopic Management of Urolithiasis)

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.080162

Received 04 February 2026; Accepted 12 May 2026; Published online 28 July 2026

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Abstract

Overview: Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for large and complex renal stones. Although it offers high stone-free rates, it remains associated with a significant risk of complications, particularly infectious events. Intrarenal pressure (IRP) has emerged as an important yet underrecognized determinant of safety during PCNL. Objectives: This article aims to describe a practical technique for real-time IRP monitoring during various PCNL procedures using a retrograde, open-ended ureteral catheter connected to a fluid-filled pressure transduction system and standard anesthesia monitoring equipment. We also report our initial clinical experience with IRP monitoring during standard and Mini-PCNL procedures performed in both supine and prone positions. Baseline, median, and Peak IRP values are reported in this article.