North America Percutaneous Nephrolithotomy Market

North America Percutaneous Nephrolithotomy Market Size

The North America percutaneous nephrolithotomy market was valued at USD 479.8 million in 2024. The market is expected to reach from USD 501.5 million in 2025 to USD 858.5 million in 2034, growing at a CAGR of 6.2% during the forecast period, according to the latest report published by Global Market Insights Inc. The high market growth is attributed to the ongoing advancements in minimally invasive urology, strong healthcare infrastructure, rising prevalence of kidney stones, and favourable reimbursement policies, among other contributing factors.

Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical operation that helps in the removal of large or complicated kidney stones which are not amenable to extracorporeal shockwave lithotripsy or ureteroscopy. The method comprises making a small cut in the patient’s back to obtain direct access to the kidney with a nephroscope. In this way, any part can be broken down and removed with a very high success rate and the least possible damage to the tissue and a short recovery time.

The leading players in the percutaneous nephrolithotomy market are OLYMPUS, Boston Scientific, KARL STORZ, Richard Wolf, and Dornier MedTech. These firms maintain their competitive advantage through constant product innovation, regional market presence, and considerable investments in research and development.

The market has increased from USD 418.2 million in 2021 and reached USD 458.1 million in 2023, with the historic growth rate of 4.7%. The market growth was driven by increasing procedural volume in high-acuity hospitals, rising burden of recurrent nephrolithiasis cases, growing surgeon preference for PCNL in complex and large renal stones, and advancements in imaging guidance and perioperative management.

Moreover, the growing incidence of nephrolithiasis in the U.S. and Canada is a major driver of PCNL demand. Lifestyle factors such as high sodium intake, obesity, diabetes, and dehydration contribute significantly to stone formation. According to urology associations, nearly 1 in 10 Americans will develop kidney stones during their lifetime. This rising burden boosts surgical interventions like PCNL, especially for large and complex stones.

Furthermore, technological innovation in urological surgery, including mini-PCNL, ultra-mini PCNL, and micro-PCNL, has improved stone removal efficiency with less tissue trauma. Enhanced visualization tools, image-guided systems, and advanced nephroscopes support precise stone fragmentation. These improvements reduce complications, shorten recovery time, and drive adoption across hospitals and ambulatory surgical centers.

North America Percutaneous Nephrolithotomy Market Trends

The North America percutaneous nephrolithotomy industry is growing considerably with the shift towards miniaturized PCNL techniques, integration of digital and 3D imaging in PCNL, rise in ambulatory surgical centers performing PCNL, and increasing use of laser lithotripsy devices, among other factors collectively driving industry growth.

• A major trend is the increasing adoption of mini-PCNL, ultra-mini PCNL, and micro-PCNL techniques due to lower bleeding risk and reduced postoperative pain. These techniques use smaller tract sizes and are preferred in paediatric and obese patients. This trend is reshaping procedural standards across urology centers in the U.S. and Canada.
  
• PCNL procedures are increasingly using 3D imaging, augmented fluoroscopy, and intraoperative ultrasound for improved surgical navigation. These technologies enhance precision during percutaneous renal access and reduce complications. Image-guided PCNL is becoming standard in high-volume hospitals across North America.
  
• Further, there is a growing shift of PCNL procedures from hospitals to ambulatory surgical centers (ASCs) due to cost efficiency and faster patient turnover. Advancements in anesthesia and instrument design have shortened recovery times, enabling same-day discharge for PCNL patients. This trend also benefits device manufacturers targeting mid-sized urology centers, thereby sustaining market growth.
  

North America Percutaneous Nephrolithotomy Market Analysis

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The market was valued at USD 418.2 million in 2021. The market size reached USD 458.1 million in 2023, from USD 437.6 million in 2022.

Based on the product type, the North America percutaneous nephrolithotomy market is segmented into nephroscopes, lithotripsy systems, access systems, and other product types. The nephroscopes segment has asserted its dominance in the market by securing a significant market share of 36.4% in 2024 owing to the growing adoption of high-definition and digital flexible nephroscopes that enhance procedural accuracy, reduce operative time, and improve clinical outcomes in complex kidney stone surgeries. The segment is expected to exceed USD 302.5 million by 2034, growing at a CAGR of 5.8% during the forecast period.

On the other hand, the access systems segment is expected to grow with a CAGR of 6.7%. The growth of this segment is driven by advancements in balloon and telescopic dilators, hydrophilic guidewires, and safety access sheaths that reduce procedure time and minimize tissue trauma.

• The nephroscopes segment continues to dominate the market. The growing prevalence of renal calculi, particularly large and complex stones, is increasing the number of PCNL procedures in the U.S. and Canada. Nephroscopes are essential visualization tools in these surgeries, making them a critical component of the procedure workflow. As hospital surgical volumes rise, demand for advanced nephroscopes increases proportionally.
  
• In addition, manufacturers are introducing high-definition nephroscopes, fibre-optic scopes, and digital video nephroscopes with superior image clarity and durability. Innovations like narrower shafts, enhanced irrigation systems, and modular designs improve maneuverability inside the kidney. These performance improvements drive adoption in both adult and pediatric urology.
  
• The lithotripsy systems segment held a revenue of USD 160.1 million in 2024, with projections indicating a steady expansion at 6.5% CAGR from 2025 to 2034. The segmental growth is driven by the rising prevalence of complex renal calculi requiring fragmentation during minimally invasive procedures, along with technological advancements such as high-power laser lithotripsy and mobile C-arm integration that enhance stone clearance efficiency.
  
• The access systems segment accounted for significant revenue in 2024, with projections indicating a steady expansion at 6.7% CAGR from 2025 to 2034. The segment is driven by the increasing adoption of image-guided percutaneous entry techniques supported by advanced fluoroscopy and ultrasound navigation, along with growing use of disposable access kits and hydrophilic guidewires that improve procedural safety and reduce cross-contamination risks.
  

Based on procedure type, the North America percutaneous nephrolithotomy market is segmented into standard PCNL, mini-PCNL, and micro-PCNL. The standard PCNL segment dominated the market in 2024, accounting for USD 272.3 million and is anticipated to grow at a CAGR of 6.1% during the forecast period.

• Standard PCNL is preferred in patients with anatomical abnormalities such as horseshoe kidney, calyceal diverticulum, or ureteropelvic junction obstruction. These complex conditions are challenging for flexible ureteroscopes and SWL, reinforcing the clinical dependence on standard tract size PCNL procedures.
  
• Standard PCNL is supported by well-equipped operating rooms in both large hospitals and regional surgical centers. Established supply chains for dilators, sheaths, nephroscopes, and access kits support procedural continuity. Proven clinical workflows and availability of surgical teams ensure widespread procedural readiness.
  
• The mini-PCNL segment accounted for significant revenue in 2024 and is anticipated to grow at a CAGR of 6.5% over the forecast period. The growth of the segment is driven by rising preference for minimally invasive stone removal with reduced bleeding and shorter hospital stays, supported by increasing adoption of miniaturized endoscopic instruments for high-risk and pediatric patients.
  
• The micro-PCNL segment held a revenue of USD 57.1 million in 2024, with projections indicating a steady expansion at 5.5% CAGR from 2025 to 2034. The segment is driven by its expanding use in patients with small renal calculi and anatomically challenging cases, supported by ultra-miniaturized access tracts that minimize renal trauma and postoperative complications.
  

Based on patient, the North America percutaneous nephrolithotomy market is segmented into adult and pediatric. The adult segment dominated the market in 2024, accounting for USD 408.9 million and is anticipated to grow at a CAGR of 6% during the forecast period.

• The adult working population prefers PCNL due to faster recovery times and shorter hospital stays compared to open surgery. Modern anaesthesia techniques and enhanced post-operative care improve procedure safety in adults. This preference supports continued adoption in hospitals and ambulatory surgical centers.
  
• Public and private insurers in the region are willing to reimburse most readily for adult PCNL procedures, as they are considered a medical necessity in complex stone disease. As a result, adults are frequently treated with PCNL as the first step for a high stone burden, thus making reimbursement more straightforward. This improves hospital procedural volume and device utilization.
  
• The pediatric segment accounted for significant revenue in 2024 and is anticipated to grow at a CAGR of 7.2% over the forecast period. The growth of the segment is driven by the rising incidence of pediatric urolithiasis linked to metabolic disorders and dietary shifts, along with increasing availability of child-specific endourology instruments and specialized pediatric urology centers.
  

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Based on end use, the North America percutaneous nephrolithotomy market is classified into hospitals, ambulatory surgical centers, and other end users. The hospitals segment dominated the market with a revenue share of 62.7% in 2024 and is expected to reach USD 533 million within the forecast period.

• Hospitals are the primary treatment centers for patients with large or complicated kidney stones requiring PCNL. They handle emergency admissions for obstructive uropathy, renal infections, and recurrent stone disease. This steady patient flow drives a higher volume of PCNL procedures in hospital settings.
  
• Moreover, hospitals in the U.S. and Canada have well-equipped operating rooms, fluoroscopy units, ultrasound guidance systems, and powerful lithotripters. This makes them more capable of performing PCNL than small clinics. Their access to multidisciplinary support enhances procedure safety and efficiency.
  
• The ambulatory surgical centers segment accounted for significant revenue in 2024 and is anticipated to grow at a CAGR of 6.7% over the forecast period. The segment is driven by increasing patient preference for faster recovery and shorter waiting times, along with expanding investments by private healthcare providers in urology-focused ASCs equipped with advanced imaging and endourology suites.
  

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U.S. Percutaneous Nephrolithotomy Market

The U.S. percutaneous nephrolithotomy market was valued at USD 394.6 million and USD 412.3 million in 2021 and 2022, respectively. The market size reached USD 450.8 million in 2024, growing from USD 431 million in 2023, and is anticipated to grow at a CAGR of 6% between 2025 to 2034.

• The U.S. is among the countries with the highest recurrence rates of kidney stones in the world, up to 50% within 5 years. Patients with recurrent stones are likely to have complex and larger stones that will require PCNL for complete clearance. Such a patient pool constitutes a recurring demand for a continuous flow of urology procedures in departments across the country.
  
• The country is at the forefront of integrating AI-powered planning software and navigation systems in urology. AI-based renal access planning tools and digital fluoroscopy reduce surgical errors and improve outcomes. Early adoption by U.S. hospitals is accelerating demand for advanced PCNL technologies.
  
• Furthermore, the presence of major medical device companies such as Boston Scientific, Stryker, Cook Medical, and Teleflex strengthens PCNL product availability in the U.S. The frequent product upgrades, clinical trials, and collaborations with teaching hospitals are the key to innovation. Domestic manufacturing also reduces supply chain delays and supports market growth.
  

Canada Percutaneous Nephrolithotomy Market

The Canada percutaneous nephrolithotomy market is anticipated to grow at the highest CAGR of 8.3% during the analysis timeframe.

• Canada experiences higher kidney stone rates, especially in provinces like Alberta, Ontario, and Quebec, due to low fluid intake during long winters. The Canadian Urological Association (CUA) reports a steady rise in urolithiasis cases over the past decade. This increasing disease burden drives demand for PCNL procedures across the country.
  
• Canadian healthcare policy encourages the use of minimally invasive surgeries (MIS) to reduce hospital resource utilization and improve patient recovery times. Funding incentives and provincial modernization programs support adoption of endourology technologies, including PCNL kits and equipment.
  
• Moreover, the country’s hospitals emphasize radiation safety protocols. As a result, ultrasound-guided or hybrid PCNL techniques are being increasingly used to minimize fluoroscopy exposure. This focus on safer access methods improves procedural outcomes and encourages adoption across teaching hospitals.
  

North America Percutaneous Nephrolithotomy Market Share

The North America percutaneous nephrolithotomy industry is moderately competitive, characterized by strong product portfolios, continuous R&D investments, and expanding clinical partnerships with urology centers. Key players include OLYMPUS, Boston Scientific, KARL STORZ, Richard Wolf, and Dornier MedTech, collectively accounting for ~67% of the total market share. These companies dominate through broad offerings in nephroscopes, lithotripsy systems, dilators, and access kits.

Strategic initiatives such as product launches in mini and micro PCNL systems, advancements in laser lithotripsy, and surgeon training programs strengthen their competitive position. Meanwhile, emerging players and regional manufacturers compete through cost-effective devices and distribution partnerships, especially in niche and outpatient settings.

North America Percutaneous Nephrolithotomy Market Companies

A few of the prominent players operating in the North America percutaneous nephrolithotomy industry include:

• ADVIN
• B. BRAUN
• Becton, Dickinson and Company
• Boston Scientific
• Coloplast
• COOK MEDICAL
• Dornier MedTech
• ELMED
• EMS ELECTRO MEDICAL SYSTEMS
• KARL STORZ
• OLYMPUS
• Richard Wolf 
• Teleflex
  
• OLYMPUS

Olympus differentiates itself with a comprehensive endourology portfolio, including advanced rigid and flexible nephroscopes that deliver superior visualization and ergonomic handling. Its strong clinical training programs and partnerships with top urology centers in the U.S. enhance procedural adoption and brand loyalty.

• KARL STORZ

KARL STORZ is known for precision-engineered nephroscopes and modular PCNL systems that offer durability and compatibility with a wide range of accessories. Its innovations in miniaturized instrumentation for Mini-PCNL and Micro-PCNL support minimally invasive surgical advancements across the region.

• Boston Scientific

Boston Scientific stands out with cutting-edge laser lithotripsy systems such as the LithoVue and Holmium laser solutions that significantly improve stone fragmentation efficiency. Its strong distribution network and hospital procurement relationships ensure deep market penetration across U.S. surgical centers and ASCs.

North America Percutaneous Nephrolithotomy Industry News

• In February 2025, Ambu announced the expansion of its European regulatory clearance (CE mark) for the Ambu aScope 5 Cysto HD solution, enabling its HD technology to function as a single-use flexible cysto-nephroscopy system. This development is anticipated to strengthen the regional market by supporting infection-free procedures and reducing sterilization-related downtime, while accelerating the adoption of disposable nephroscopy solutions across hospitals and ambulatory surgery centers.
  

The North America percutaneous nephrolithotomy market research report includes an in-depth coverage of the industry with estimates and forecast in terms of revenue in USD Million from 2021 – 2034 for the following segments:

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Market, By Product Type

• Nephroscopes
  • Rigid
  • Flexible
• Lithotripsy systems
• Access systems
• Other product types

Market, By Procedure Type

• Standard PCNL
• Mini-PCNL
• Micro-PCNL

Market, By Patient

• Adult
• Pediatric

Market, By End Use

• Hospitals
• Ambulatory surgery centers
• Other end use

The above information is provided for the following countries:

• U.S.
• Canada