Comparative Study of Modified Supine versus Standard Prone Position in Percutaneous Nephrolithotomy: A Prospective Randomized Trial

Percutaneous nephrolithotomy (PCNL) is the standard treatment for large renal stones, traditionally performed in the prone position. However, the supine approach has gained attention due to anesthetic advantages and potential reduction in complications. This prospective randomized study compared 30 patients undergoing modified supine PCNL with 30 patients in the prone position. Outcomes assessed included operative time, stone-free rate, hospital stay, pain, and complications. Supine PCNL significantly reduced operative time and major complications while maintaining comparable stone clearance. Findings suggest the supine approach is a safe and efficient alternative, particularly for obese or high-risk patients.