Percutaneous Nephrolithotomy

Overview

What is a percutaneous nephrolithotomy?

Percutaneous nephrolithotomy is a procedure to remove problem kidney stones that are too large to pass on their own. Typically this procedure is used when other methods are unsuccessful or not possible.

Why would someone need a percutaneous nephrolithotomy?

Most kidney stones don't require surgical intervention and removal. However, when kidney stones don't pass on their own, they can be extremely painful. Additionally, some stones are not resolved through other methods like extracorporeal shock wave lithotripsy. In such cases, your doctor may recommend a percutaneous nephrolithotomy.

Procedure Details

What happens before a percutaneous nephrolithotomy?

Your doctor may choose to use CT, ultrasound, or x-ray imaging to better see the kidney stones to be removed. After imaging is done, you will be given general anesthesia to put you to sleep for the duration of the procedure.It is recommended not to eat anything after midnight the day before the procedure. This is to help prevent potential nausea from general anesthesia.

What happens during a percutaneous nephrolithotomy?

You will be guided to the operating room where surgeon will make a small incision in your back. Then s/he will insert a protective sleeve called a sheath through your back and into your kidney. Your doctor will use a nephroscope (a small video camera) through the sheath to locate and remove the kidney stones.Your doctor may also install a nephrostomy tube or ureteral stent at the end of the procedure to help drain urine and encourage your kidney to heal.If your doctor thinks it is necessary, he will send the removed kidney stones to our laboratory to have them tested.

What happens after a percutaneous nephrolithotomy?

You will be escorted into a recovery room and monitored by our nurses while you wake up from the anesthesia. Most patients recover enough to be sent home one or two days after the procedure. It is important to avoid heavy lifting or strenuous exercise for two to four weeks after a percutaneous nephrolithotomy.In the event that your doctor did install a drainage tube in your kidney, you’ll need to monitor for any signs of bleeding. If you notice significant bleeding in your urine or from the tube (particularly if you notice blood clots, or blood that resembles ketchup), go to the emergency room.Additionally, you will want to monitor yourself for a fever or chills. If you experience either, contact your doctor. These are symptoms of an infection and need to be treated immediately. Contact your doctor if you experience pain that is not resolved by the prescribed pain medication.Your doctor will likely want you to have a checkup 4 to 6 weeks after the procedure. During which s/he will do some tests to determine what the next steps should be for your care.

Reviewed by a Cleveland Clinic medical professional.

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