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Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure used to remove large kidney stones (greater than 2 cm) that cannot pass through urine. This procedure involves making a small incision over the abdomen to access and remove the stones from the kidney.
Kidney stone extraction
Kidneys, ureters, and urethra
Percutaneous surgical procedure
Compared to traditional surgical methods, PCNL offers several benefits:
Before undergoing PCNL, several imaging tests are conducted, such as abdominal ultrasound, CT scans, or MRI, to locate the kidney stones. A mid-stream urine test is also required. Other tests may include:
The procedure is done under general anesthesia to ensure the patient feels no pain. The patient is positioned on their stomach, and a small 1 cm incision is made in the back. A hollow tube is inserted into the kidney under X-ray guidance, and surgical tools are used to remove the stone.
A drainage nephrostomy tube is placed in the kidney, along with a urethral catheter to drain urine. The patient may stay hospitalized for 2-4 days, depending on their health condition. A post-surgery X-ray is taken to confirm the stone has been completely removed. A DJ stent is typically placed and removed after 2 weeks.
A follow-up appointment is scheduled one week after the surgery to monitor recovery. Tests are repeated to ensure the procedure was successful, and the catheter is removed after assessing kidney function. Antibiotics and painkillers are prescribed to prevent infection and manage pain.
If the patient experiences severe pain, fever, or infection, it is important to contact the urologist. After a few days, patients can begin to move around and gradually resume normal activities. Lifting heavy objects or engaging in strenuous activities should be avoided for some time after surgery.
Recovery time varies depending on the patient’s overall health. It is common to experience blood-tinged urine for a few days after the surgery. However, if there is severe pain or bleeding, medical attention should be sought immediately.
Patients typically regain full function after two weeks, but it is important to continue rest and maintain a healthy diet to support recovery. Dietary adjustments may be recommended to prevent the formation of new stones. Maintaining adequate water intake helps flush out any remaining small stones and reduces the risk of further stone formation.
Although PCNL is a safe procedure, there are some risks involved: