What happens before PCNL?
Before percutaneous nephrolithotomy, you’ll meet with a healthcare provider. They’ll check your general health and take your vitals (temperature, pulse and blood pressure).
Tell your healthcare provider about any prescription or over-the-counter (OTC) medications you’re taking. These include herbal supplements. Aspirin, anti-inflammatory drugs, certain herbal supplements and blood thinners can increase your risk of bleeding. Be sure to check with a healthcare provider before stopping any medications.
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Tell your healthcare provider about any allergies you have, as well. Include all known allergies. These include medications, skin cleaners like iodine or isopropyl alcohol, latex and foods.
Your healthcare provider will also give you specific directions on eating and drinking before your PCNL. You shouldn’t eat or drink anything after midnight the night before your surgery. If you must take medications, you should take them with a small sip of water.
They may also order imaging tests to get a better view of the kidney stone. Before surgery, your provider may order:
- CT (computed tomography) scan.
- Ultrasound.
- X-ray.
What happens during PCNL?
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A special team of healthcare providers will perform percutaneous nephrolithotomy. The team typically includes:
- A urologist.
- An anesthesiologist.
- Nurses.
During most PCNL procedures, you’ll lie on your stomach (prone), so the urologist can access your kidney through your back. However, the urologist may position you on your back (supine) or on your back with a cushion under your flank (modified supine).
The anesthesiologist will sedate you (put you under) with general anesthesia. You won’t be awake, won’t move and won’t feel any pain during the procedure.
Once you’re asleep, the urologist will make a small (approximately 1 cm or smaller) incision. They’ll insert a protective sleeve (sheath) through the incision and into your kidney. They’ll then insert a small video camera (nephroscope) into the sheath to locate and remove the kidney stone. In some cases, the urologist may use a laser or shock-wave device (lithotripter) to break the stone into smaller pieces before removing it.
After removing the kidney stone, the urologist may install a drainage tube or a ureteral stent. These help drain urine (pee) and promote healing. They may then use stitches to close your skin incisions.
How long does PCNL take?
PCNL usually takes two to four hours to perform.
What happens after PCNL?
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After PCNL, a healthcare provider will cover your stitches with bandages.
They may also send the kidney stone to a lab so technicians can determine its composition. Identifying a kidney stone’s components can help determine its cause and prevent new stones from forming.
The anesthesiologist will stop putting anesthesia into your body. You’ll be conscious (awake) within a few minutes, but you’ll likely still feel groggy.
You’ll then move to a recovery room. Healthcare providers will wait for you to wake up more fully and track your overall health. Once you fully wake up, providers will treat your pain. PCNL is a minimally invasive surgery, but you may still need pain medication and management techniques.
You’ll typically need to stay in the hospital for one day after your surgery so your providers can monitor your recovery, make sure you’re beginning to heal and aren’t having issues with pain management.
You may have a small amount of blood in your pee for one to two weeks after surgery. This is normal.
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