Background Reintervention is typically difficult owing to perinephric anatomical changes in individuals with a history of open stone surgery. Aim The aim of the current study was to see what effect open renal surgery may have on the effectiveness and morbidity of later percutaneous nephrolithotomy (PCNL). Patients and methods PCNL was performed on 100 patients between March 2017 and March 2018. Overall, 20 of these patients were eliminated (tubeless or bilateral simultaneous PCNL). The remaining 80 patients were divided into two groups: 40 primary patients and the rest (history of open nephrolithotomy). Before intervention, a standard preoperative assessment was conducted. Statistical analysis was performed using SPSS v. 20 with the χ 2 test and the independent samples t-test. P value <0.05 was considered statistically significant. Results In terms of demographics and stone load, both groups were comparable. Group 1 had fewer attempts to access the pelvicalyceal system than group 2 (1.2 ± 0.5 vs. 2.7 ± 0.9, respectively), which was statistically significant (P=0.001*). Moreover, there was a statistically significant difference in the mean operational time between the two groups (85.24 ± 19.47 vs. 128.39 ± 17.45 min, respectively), with a statistically significant difference (P=0.001*). The rate of blood transfusion was similar in both groups (P=0.396). The remaining problems in both groups were similar. Conclusion Patients with renal stone surgery might require additional attempts to reach the pelvicalyceal system and may have difficulties with tract dilatation owing to retroperitoneal fibrosis. However, the overall morbidity and efficacy are the same in both groups.