Selection of surgical procedure for elective kidney stone removal

PNL: percutaneous nephrolithotomy; CT: computed tomography; HU: Hounsfield units; URS: ureteroscopy; SWL: shock wave lithotripsy.
* If PNL is not available or contraindicated, staged URS (ie, performed in separate planned sessions) is an alternative option.
¶ Stones with high attenuation on CT have a harder stone composition and are less likely to be disintegrated by SWL.