Nephroscopy

Nephroscopy is a procedure healthcare providers use to examine the inside of your kidney. They can also use it to treat kidney stones and other upper urinary tract conditions.

Providers perform a nephroscopy with a lighted tube with a camera on the end (nephroscope). They insert the nephroscope into your body through a small cut in the skin of your back or side.

Providers can also use surgical instruments through the nephroscope. For instance, they can use a laser or an ultrasonic probe to break apart kidney stones. Once they break the stone, your provider can remove fragments and small pieces through the scope.

When is nephroscopy used?

Healthcare providers most commonly use nephroscopy to break up and remove larger kidney stones (sometimes called percutaneous nephrolithotomy or PCNL). Providers use PCNL if other procedures, like shock wave lithotripsy or ureteroscopy, can’t break up the stone, or if there’s so much stone that it’s unlikely other procedures would remove all the stone.

Nephroscopy may be used to treat or remove:

• Kidney stones
• Small tumors
• Foreign bodies

How do I prepare for nephroscopy?

Your provider will give you instructions on how to prepare for a nephroscopy. Following their directions closely can reduce your risk of complications. Before a nephroscopy, your provider may ask you to:

• Avoid eating anything for eight hours before the procedure (fast).
• Stop taking medications before the procedure or take them with just a sip of water. Don’t stop taking medications unless your provider tells you to.
• Ask someone to drive you home after the procedure.
• Provide a urine (pee) sample to check for a urinary tract infection (UTI). If you have an infection, you may have to take an antibiotic.

What happens during nephroscopy?

Before a nephroscopy, your provider will give you anesthesia through an IV in your arm. This means you’ll be asleep during the procedure.

During a nephroscopy, a provider will:

1. Position you on the operating table, lying face down, on your stomach, or slightly tilted, on your back.
2. Place a small catheter through your urethra (the tube that drains pee from your bladder to the outside of your body) into your kidney.
3. Inject a contrast agent (dye) into the catheter and take X-rays to show details of the inside of your kidney.
4. Insert a needle through the skin on your back and into your kidney, guided by X-rays or ultrasound to ensure safety.
5. Dilate (widen) the area and insert a sheath (tube). The sheath allows the nephroscope — and other surgical instruments — direct access to the inside of your kidney.
6. Break up and/or remove kidney stones or remove/ablate (burn) tumors.
7. Place a stent (tube) in your ureter. Your ureter is the duct that allows urine to pass from your kidney to your bladder. The stent holds your ureter open, which helps your body drain urine and encourages your kidney to heal. Or they may place a nephrostomy tube, which drains your kidney and exits through the same incision the nephroscopy was performed through.

What happens after nephroscopy?

After nephroscopy, a provider will take you to a recovery room and monitor you while you wake up from the anesthesia. Most people go home after recovery, but you may have to stay a day for observation, depending on how the procedure went. Your provider will let you know how long you can expect to stay.

A provider usually removes the stent in your ureter within a week after the procedure.

What are the advantages of nephroscopy?

Nephroscopy reduces the need for traditional surgery to remove kidney stones and tumors. The recovery time is shorter, and there’s less risk of infection and bleeding than with traditional surgery.

What are the risks?

Risks and possible complications of nephroscopy include:

• Pain
• Bleeding
• Infections
• Injury to your ureter or kidney

How soon after nephroscopy will I feel better?

You might feel well enough to get back to your regular activities within a week of a nephroscopy. Avoid heavy lifting and strenuous exercise for two to four weeks, as they could cause bleeding from the incision or in your pee. Take any medications, like antibiotics, as prescribed by your provider.

When should I call my healthcare provider?

Contact your provider if you have questions at any time after your procedure. Call them right away if you have unexpected symptoms or pain that isn’t manageable with your prescription medication.

Go to the emergency room if you experience:

• Fever
• Chills
• Heavy bleeding or blood clots in your pee