True Supine Percutaneous Nephrolithotomy for Recurrent Right Renal Calculi in a Previously Operated Kidney: A Case Report and Review of the Literature

Background: Percutaneous nephrolithotomy (PCNL) is the standard treatment for large or complex renal calculi. True supine positioning offers anesthetic and logistical advantages, but its use in a previously operated kidney is less well described. Case presentation: A 55-year-old woman with no known comorbidities presented with right flank pain of 6 months' duration and intermittent mild dysuria. She had undergone right PCNL 1.5 years earlier. Non-contrast CT showed [right renal calculi: number, size, location, HU]. She underwent right PCNL in the true supine position through three tracts. The operative time was 1.5 hours, and the procedure was uneventful. A right DJ stent was placed at the end of the procedure. Haemoglobin fell from 12.4 to 11.6 g/dL, and serum creatinine remained normal. She was discharged on postoperative day 3. Conclusion: True supine PCNL is a feasible and safe option for recurrent stones in a previously operated kidney, with minimal haemoglobin drop and preserved renal function.