1. Physical examination: The doctor checks the physical health, symptoms, and medical history of the patient.
2. Imaging tests: Imaging tests such as x-rays, abdominal ultrasounds, and MRI scans help the doctor in obtaining a clear image of the internal organs and determine the precise location of the stone.
3. Blood urea nitrogen (BUN) test: This test helps to evaluate how well the kidneys are functioning.
4. Blood tests: These tests help in checking the different blood parameters and if there is a presence any underlying medical condition present.
5. Urinalysis: It helps to check if there are any stones present and the composition of the stones that may be present.

• The procedure is generally done under general anesthesia (the patient is made unconscious before the procedure).
• A tiny incision or cut of about 1 cm is made in the flank (lower back) region.
• A nephroscope (thin, flexible scope) is inserted under x-ray guidance by the surgeon through the incision made.
• The nephroscope helps the doctor to visualize the stones and determine their exact location.
• A thin needle is then used to access the kidney’s urine collecting system and dilate the route carefully. This is done by using a guidewire that will allow the nephroscope to access the kidneys safely.
• Once the doctor located the stones, the surgeon may choose to either break the stone into fragments or remove it entirely using microforceps.
• In certain cases, DJ stenting may be needed, which allows the pieces of the stone to flush out through the urine.
• Ureteral stents are hollow, thin tubes inserted through the urethral opening to reach the kidneys.
• Ureteral stents may be kept in the body for approximately 10 to 14 days, depending on how long it takes for the stones to flush out of the body completely.

The complications associated with a PCNL procedure are:

• Infection
• Bleeding
• Incomplete removal of the stone
• Injury to the kidney or other surrounding organs
• Failure to remove the stone
• Need to convert to open surgery 

1. The patient is usually discharged from the hospital the day after the procedure.
2. It is normal to have some pain and discomfort due to the insertion of the ureteral stents. The doctor may prescribe certain medicines to relieve the pain.
3. The patient will have blood in the urine for many days or weeks after the procedure.
4. The doctor will prescribe painkillers and antibiotics after the procedure.
5. The patient needs to drink lots of fluids throughout the day to flush out the fragments of the stones and blood from the body.
6. The patient can resume work within a few days after the procedure.

Home remedies:

1. Drink plenty of fluids throughout the day to help urine flow and the drainage of small stone fragments spontaneously.
2. Eat a fiber-rich diet to help in having easy bowel movements and quicker inner healing.
3. Take plenty of rest for the first week after the procedure. Avoid heavy lifting and strenuous activities during this period.

Cost of PCNL surgery in India-

The cost of PCNL surgery in Mumbai is between INR 65,000 to INR 1,20,000.
The cost of PCNL surgery in Delhi is between INR 60,000 to INR 1,10,000.
The cost of PCNL surgery in Bangalore is between INR 60,000 to INR 1,10,000.
The cost of PCNL surgery in Chennai is between INR 55,000 to INR 1,00,000.