Management of Renal Stones >2 cm in the Modern Endourology Era: Does PCNL Remain the Gold Standard?

Background

Percutaneous nephrolithotomy (PCNL) remains the reference treatment for renal stones larger than 2 cm because of its high single-session stone-free rate. However, advances in flexible ureteroscopy (fURS), laser lithotripsy, suction-assisted access systems, and endoscopic technology have expanded the role of retrograde intrarenal surgery (RIRS) in patients who historically would have been treated primarily with PCNL.