Percutaneous Nephrolithotomy also known as PCNL surgery is a procedure for treating multiple, complex, large stone (larger than 2 cm), stone caused by an infection or not broken up by extracorporeal shock (ESWL).
There are many benefits of PCNL procedure including:
o Can remove large or multiple stones
o High success rate
o Less pain
o Shorter recovery period
o No urine leakage
o Less hospital stay
Patient may require undergoing some tests such as electrocardiogram (ECG), X-rays, blood and urine tests to see the exact location of the stone and should discuss with the doctor if the patient is pregnant, has any allergies to medicines or if he/she is taking any medicines that may increase the risk of bleeding or non-steroidal anti-inflammatory drugs. Many medicines can affect platelet function also. Patient will be advised not to eat or drink a night before surgery.
PCNL is done under the influence of general anesthesia. Doctor will make a small incision in the patient’s back and will place a protective sleeve through the back and into the kidney. Nephroscope (video scope) will be placed through this sleeve to locate and remove the kidney stone. The procedure is done with the assistance of X-ray imaging or ultrasound to guide the hollow tube into the kidney to remove the stones with laser fibers and stone grasping instruments. This drainage catheter will be left in the kidney at the end of the procedure to let the kidney heal and drain the urine. Patient may see some blood streaks in the urine for up to a week after discharge. In some cases, further follow – up surgery is required using pyeloscopy and laser to remove any remaining stones from the kidney. Doctor may prescribe some antibiotics to prevent infection or painkillers to the patient who may experience minimal wound discomfort post surgery.
PCNL procedure is minimal invasive surgical procedure that does not have any specific side effects as compared to traditional techniques in managing large complex stones and improved techniques have made this surgery safer. But still there are few complications or risk associated with it such as:
o Pain in kidneys, abdomen, lower back and sides
o Discomfort and pain while urinating
o Heavy bleeding in urine
o Nausea and vomiting
o Colon or bladder injury
o Side effects on kidney function
Patient should inform doctor if there are blood clots in the urine, severe abdominal pain, breathlessness, high fever, persistent leakage from nephrostomy site. It is recommended to drink plenty of fluids, eat healthy food and exercise daily to improve overall health.