Percutaneous Nephrolithotomy (PCNL)

Percutaneous – means through the skin. Nephrolithotomy – is a combination of the words nephro (kidney), litho (stone) and tomy (removal). Nephrolithotripsy – is a combination of the words nephro (kidney) litho (stone) and trispy (crushed). PCNL may be a combination of both of these.

This procedure is a treatment for kidney stones where patients have large or multiple stones measuring greater than 2cm of total stone burden. They involve entering the kidney through a small incision in the back. The purpose of the procedure is for the removal of the renal calculi in order to relieve pain, bleeding into or obstruction of the urinary tract, and/or urinary tract infections.

WHAT DOES THE PROCEDURE INVOLVE?

The procedure is performed under a general anaesthetic and lasts approximately two hours. It is a team effort requiring coordination between your surgeon, anaesthetist and radiographer. The procedure is accomplished with the assistance of x-ray imaging / ultrasound to guide the entry of a hollow tube into the kidney, through a keyhole incision in your back. This provides access into the kidney drainage system allowing telescopes, lithoclast (small high frequency jack hammer), laser fibres and stone grasping instruments to visualise, fragment and remove the kidney stones. A nephrostomy tube (a drainage catheter that’s inserted through your skin and into your kidney to drain urine) will be inserted at the conclusion of the procedure. The nephrostomy tube drains urine from the kidney into a drainage bag. You will also have an indwelling catheter (IDC) in place to allow your urine output to be measured from the bladder. You may also have a ureteric catheter draining into the IDC. A ureteric catheter is a small flexible plastic internal tube that is placed into the ureter to further promote drainage of your kidney in conjunction with the nephrostomy. The nephrostomy tube, ureteric catheter and IDC will all be removed prior to you being discharged from hospital, approximately 2 days after your procedure. If a ureteric stent is placed, its removal will be determined by your surgeon, depending if further procedures need to be performed for your stones.

WHAT CAN I EXPECT AFTER THE PROCEDURE?

WHAT ABOUT DIET?

WHAT ABOUT EXERCISE/ACTIVITY?

WHAT ABOUT MEDICATIONS?

WHAT ARE THE POSSIBLE COMPLICATIONS?

NOTIFY GM UROLOGY or your GP if you experience any of the following:

FOLLOW UP APPOINTMENT

Your doctor will generally speak to about the results of the procedure before you are discharged home and an appointment for your follow-up in approximately 4 weeks will be organised. If an appointment time is not given to you on discharge from hospital, you will need to phone GM Urology to make an appointment.
If you have any queries please contact GM Urology on 03 5201 7000 during business hours OR leave a message on the After Hours Urology Paging Service 03 9387 1000