Percutaneous nephrolithotomy (PCNL) is a minimally-invasive surgery that helps in removing all types of stones from the kidney. Larger than two centimetre-sized stones of any kind can be removed with this treatment from the kidney and higher urinary tubes.
Nephrostomy is a procedure where the doctor places a tube inside the kidney or ureter. It helps in draining the urine from the kidney after PCNL. It gives time for the kidney to heal quickly post PCNL
How is PCNL and Nephrostomy performed? Before, during and after.
Medical professionals ask the patient to stop using certain medications they are currently taking that may alter the clotting effect of the blood. It is to prevent excessive bleeding during the surgery.Â
The doctors will check for any signs of urinary tract infections or (UTIs). The patient must also undergo necessary tests and treatment before the procedure.
Healthcare professionals place the patient under anaesthesia during PCNL + Nephrotomy. The surgeon will send a device through a small incision in the skin. The needle tract contains a small camera to view the stones. After mapping the stones with a telescope, doctors break and remove them from the body using a laser or mechanical device.Â
After that, they place a nephrostomy tube to drain the urine into a bag so the kidney can heal.
The patient may experience some side effects such as pain, nausea, etc.
Risks and complications of the PCNL and Nephrostomy
Some risks and potential complications that are associated with PCNL are:
- Bleeding: Blood loss during this procedure is generally minimal, and the risk of bleeding ranges from 2-12%, depending on the size and location of the stones.Â
- Infection: In some cases, bacteria can grow within the kidney stones and cause an infection. Hence, urinary infections should be treated before the PCNL procedure with antibiotics to lower the risk.
- Failure to Remove the Stone: There is a slight risk of this happening with PCNL.
- Organ Injury: Rarely, some organs surrounding the kidney may experience injury during surgery. Â
Who needs a PCNL and Nephrostomy?
Medical professionals typically recommend PCNL and Nephrostomy in the following conditions:
- Large kidney stones are blocking the collecting system branch of the kidney
- Kidney stones are larger than 2 centimetres
- Large stones are in the collecting tubes
- Other treatments have failed
