Percutaneous Nephrolithotomy (PCNL)
Due to stone size or complexity you and your urologist may decide to treat your kidney stone through a small incision in your back.
Prior to the procedure
Prior to your surgery you will meet with your urologist. The following may be ordered or reviewed by your urologist:
- Physical exam
- EKG (electrocardiogram)
- CBC (complete blood count)
- PT / PTT (blood coagulation profile)
- Comprehensive Metabolic Panel (blood chemistry profile)
- Urinalysis and urine culture
- Evaluation by your cardiologist and/or primary care physician
Medications to avoid one week prior to surgery include:
Our office will instruct you specifically on which medications you should stop. You will need to verify that you can stop these medications with the prescribing physician.
The surgery is performed by making a ½ inch incision in the back to gain access to your kidney. A video camera is then used to directly visualize the stone and the stone is broken up and removed.
This procedure is performed regularly at CAMC and has been shown to be very safe. However, possible complications include bleeding, infection and organ injury. In some cases multiple procedures are required to enable you to be completely stone free.
Following the procedure
Typically patients are admitted to the hospital for 1-2 days following the procedure. Complex procedures or severe infection may warrant a longer hospital stay.
You may have a ureteral stent placed as part of the procedure. This can be removed by your urologist at your follow-up appointment.
You may have a small tube coming out of your back following the procedure. This is called a nephrostomy tube; it allows urine to drain into a drainage bag. If you are discharged home with the nephrostomy tube the following instructions apply:
- Empty the drainage bag regularly including before you go to sleep at night.
- Keep the drainage bag below the level of your kidney. This ensures that urine will be able to flow into the bag.
- If you experience a decrease in urine output from the nephrostomy tube, please make sure the tube is not kinked and that the stopcock is in the open position.
- It is ok to shower with a nephrostomy tube.
- Keep the nephrostomy tube securely in place and ensure that it does not catch or pull.
- Call your urologist should you experience increased pain, fever, chills, pus forming around the insertion site, or decreased urine output into the bag.