Eryilmaz, RecepAslan, RahmiKeles, Muhammed FatihDemir, MuratTaken, Kerem2026-01-302026-01-3020262194-72282194-723610.1007/s00240-025-01904-z2-s2.0-105027705368https://doi.org/10.1007/s00240-025-01904-zhttps://hdl.handle.net/20.500.14720/29653To prospectively compare the efficacy and safety of supine versus prone percutaneous nephrolithotomy (PNL) techniques in obese patients. This prospective randomized study included 73 obese patients (BMI > 25) undergoing PNL between June 26, 2024 and June 1, 2025. Patients were assigned to supine (n = 36) or prone (n = 37) groups. Demographic data, stone characteristics, operative parameters, and complications were analyzed. Statistical analyses were performed using SPSS v26, with significance set at p < 0.05. No significant differences were found between the groups in terms of age, BMI, stone size, or hospital stay (p > 0.05). The supine group demonstrated significantly shorter operative time (79.9 +/- 17.9 vs. 97.7 +/- 16.2 min, p < 0.001) and access tract length (4.8 +/- 0.7 vs. 6.2 +/- 0.8 cm, p < 0.001). Stone-free rates, DJ stent placement, transfusion requirements, and complication rates (Clavien-Dindo classification) were comparable between the groups (p > 0.05). Both supine and prone PNL are safe and effective options for obese patients with renal stones >= 2 cm. However, supine PNL provides advantages including shorter operative time, reduced access tract length, and avoidance of patient repositioning, making it a preferable approach for this patient population.eninfo:eu-repo/semantics/closedAccessObesityKidney StonesSupine PositionProne PositionPercutaneous NephrolithotomyArticle