A Prospective Comparison of Supine and Prone Percutaneous Nephrolithotomy Techniques in Obese Patients

Objective To prospectively compare the efficacy and safety of supine versus prone percutaneous nephrolithotomy (PNL) techniques in obese patients. Materials and Methods This randomized prospective study included 73 obese patients (BMI > 25) undergoing PNL between January 2024 and January 2025. Patients were assigned to either supine (n = 36) or prone (n = 37) groups. Demographic data, stone characteristics, operative details, and complications were recorded. Statistical analysis was performed using SPSS v26. Results No significant differences were found between the groups in terms of age, BMI, stone size, or hospital stay. The supine group had significantly shorter operative time and access tract length (p < 0.001). There were no significant differences in residual stones, DJ stent usage, transfusion rates, or Clavien-Dindo complications. Conclusion Both supine and prone PNL are safe and effective in obese patients. However, the supine position offers advantages such as shorter operative time, easier anesthesia management, and reduced need for repositioning, making it a favorable option for obese individuals.