Background: Percutaneous nephrolithotomy (PCNL) technique was introduced a new era in the management of renal calculi, and day by day many changes occurred regarding the puncture points to an opaque stone as a guided landmark. We aim at comparing the outcome of many renal calculi with or without retrograde pyelography (RGP).Methods: In a randomized clinical trial 110 cases with opaque renal calculi for PCNL with stone in the calyces, in the pelvis, both in the calyx and pelvis, simultaneously, included in 2 year study. They were randomized in 2 groups, non RGP (56) and RGP (54), called interventional and control group respectively.Results: 2 groups are analyzed according to gender, age, duration of operation and hospital stay, past history of any surgical intervention on kidney and stone size. Outcome was evaluated with plain x-ray and USG abdomen. No differences in outcome were observed in between the two groups.Conclusions: Present findings conclude that there is no difference in major clinical outcome between the 2 groups. So we can say RGP is not mandatory for selected patients while doing PCN
