Munson Health
 
Percutaneous Nephrolithotomy or Nephrolithotripsy

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What to Expect

Prior to Procedure

Your doctor may do the following:
You may be asked to stop taking some medications up to one week before the procedure, like:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Blood thinners
  • Antiplatelet drugs

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the procedure.

Description of the Procedure

The surgeon will make a small incision in the back. A wire is guided through the kidney and next to the stones to make a pathway. X-rays will help locate the kidney stone(s) and map the path to them. The wire can help to widen the pathway so that an instrument with a small camera and surgical tools can be inserted. The stone may be broken apart with a probe or laser. The tools can then grab or suction out the stone pieces.
A drainage tube will be placed in the kidney to temporarily drain urine away from the kidney to the outside while the area heals. The incision will be stitched or stapled. The area may be covered with a bandage.

How Long Will It Take?

3-4 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

The usual length of stay is 1-3 days. Complications may lead to a longer stay.

Post-procedure Care

At the Hospital
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
  • Pain medications
  • Antibiotics to prevent infection
  • Medication and compression stockings to prevent blood clots
  • X-rays to look for any remaining stone fragments
  • Removal of tube—often within 48 hours of procedure
You will be asked to walk around soon after your surgery. This helps circulate blood and prevents blood clots.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
At Home
Fatigue can continue for up to a month of recovery. Exercises and regular activity may be recommended to help your recovery.
 

RESOURCES

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

Urology Care Foundation
http://www.urologyhealth.org

 

CANADIAN RESOURCES

Canadian Urological Association
http://cuameeting.org

The Kidney Foundation of Canada
http://www.kidney.ca

 

References


Gross AJ, Knipper S, et al. Managing caliceal stones. Indian J Urol. 2014;30(1):92-98.


Kidney and ureteral stones. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=32&display=1. Updated January 2011. Accessed March 11, 2014.


Nephrolithiasis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 17, 2014. Accessed March 11, 2014.


Percutaneous nephrolithotomy (PCNL). University of Florida Department of Urology website. Available at: http://urology.ufl.edu/patient-care/stone-disease/procedures/percutaneous-nephrolithotomy-pcnl. Accessed March 11, 2014.


Percutaneous nephrolithotomy/nephrolithotripsy. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/kidneystones%5FPNN.cfm. Accessed March 11, 2014.


Wong B. Percutaneous nephrolithotomy. The Hong Kong Medical Diary. 2010;14(10):14-17. Available at: http://www.fmshk.org/database/articles/04mb3%5F2.pdf. Accessed March 11, 2014.

 

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