Successful PCNL for 1.5 cm Kidney Stone in a 22 Y.O. Female with Persistent Left Flank Pain

The PACE Hospital’s expert Urology team successfully performed a Left Percutaneous Nephrolithotomy (PCNL) with Double J Stent (DJS) Placement on a 22-year-old female patient diagnosed with a left renal calculus. The procedure was aimed at removing the kidney stone, relieving urinary obstruction, and restoring normal urinary flow.

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Past Medical History

The patient had no known history of hypertension or diabetes. The absence of these comorbid conditions was considered clinically favorable, as it had minimized the risk of intraoperative and postoperative complications and had supported a smoother, more stable recovery in this case.

On Examination

On examination, the patient was in a stable general condition with normal vital signs. Cardiovascular and respiratory system examinations were normal. Abdominal examination was normal except for tenderness in the left flank. The genitourinary system was abnormal due to left flank tenderness. Nervous and musculoskeletal system examinations were normal.

Diagnosis

Upon admission to PACE Hospitals, the patient underwent a comprehensive evaluation by the Urology team, including a detailed clinical examination and review of medical history. She presented with left flank pain for three months, raising suspicion of a left renal calculus.

Imaging studies, including non-contrast computed tomography (NCCT), KUB and ultrasound of the abdomen and pelvis, revealed a non-obstructing left renal calculus measuring approximately 1.5 cm at the upper pole. The right kidney was normal. Bilateral ovaries were mildly bulky with multiple small peripheral follicles, consistent with polycystic ovarian morphology. Chest X-ray and ECG were unremarkable.

Laboratory investigations showed mild neutrophilic leukocytosis on complete blood count (CBC) and hematuria on urine analysis. Renal and liver function tests, coagulation profile, and serum electrolytes were within normal limits. Vitamin D deficiency was noted. Other metabolic parameters, including blood sugar, TSH, Vitamin B12, and glycosylated hemoglobin, were within normal limits.

Based on the confirmed findings, the patient was advised to undergo **kidney Stone treatment in Hyderabad, India**, under the expert care of the Urology Department.

Medical Decision Making

After a detailed consultation with Dr. K Ravichandra and Dr. Abhik Debnath Consultant Urologists, a comprehensive evaluation was conducted to determine the most appropriate diagnostic and therapeutic approach for the patient, presenting with left flank pain of 3 months’ duration. Based on detailed clinical evaluation and imaging studies, including CT, KUB and ultrasonography of the abdomen and pelvis, surgical intervention was deemed necessary.

It was determined that the patient had a left renal calculus measuring 1.5 cm responsible for her symptoms. Left Percutaneous Nephrolithotomy (PCNL) combined with double J stenting (DJS) was identified as the most effective intervention to achieve complete stone clearance, relieve symptoms, and prevent potential obstruction. Concurrently, medical management was advised for Vitamin D deficiency and polycystic ovarian morphology.

The patient and her family members were informed about her condition, the planned procedures, associated risks, and their potential to alleviate symptoms and improve her quality of life.

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