Aim: To evaluate PCNL in supine position under ultrasound guided puncture regarding its technical aspects, success rate and complications. Patients and Methods: The study included 47 patients. All patients with renal and or upper ureteral stones were included in this study while patients with uncorrectable coagulopathy, congenital anomalies in the kidney were excluded. PCNL in supine position was done under US guided puncture while dilatation was done under fluoroscopy. Results: 20 cases (42.5%) had pelvic stone, 18 cases (38.3%) had calyceal stone, 5 cases (10.6%) had multiple stones, 1 case (2.1%) had upper ureteic stone and 3 cases (6.4%) had stagehorn stones. 25 cases (53.2%) were right sided and 22 cases (46.8%) were left sided. Stone size was 2.9 ±1.029. 42 cases had radiopaque (89.4%), while 5 cases had radiolucent stone (10.6%). Upper calyceal puncture was done in 2 cases, middle calyceal puncture in 6 cases, lower calyceal puncture in 32 cases (68.1%), and multiple punctures in 9 cases. Stone desintigration using pneumatic lithoclast was done in 31 cases (66%), and intoto stone extraction was done in 16 cases (34%). Mean operative time was 70 minutes (60-120 minutes). The intraoperative complications were dilatation difficulties in 5 cases (10.6%), bleeding requiring transfusion in 2 cases (4.2%). Stone free rate was achieved in 44 cases (93.6%) and residual stone more than 4 mm was detected in 3 cases (6.4%). Mean hospital stay was 3.2 days (2-5 days), fever in 4 cases (8.5%), urinary leakage in 3 cases (6.4, %). Conclusion: PCNL in supine position under ultrasound guided puncture is feasible, safe, and successful with minimal complications.
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