An overview of Percutaneous Nephrolithotomy
Percutaneous nephrolithotomy (PNL) is a minimally invasive surgical procedure used to remove kidney stones that cannot pass naturally. A specialized needle is inserted into the kidney under imaging guidance, and through this needle, the surgeon uses specialized instruments to locate and remove the stones. PNL is typically recommended for large kidney stones blocking multiple branches of the collecting system, stones larger than 0.8 inches in diameter, stones in the ureter, or when other therapies have failed. The procedure is performed under general anesthesia.
What is Percutaneous Nephrolithotomy used for?
Percutaneous nephrolithotomy (PNL) is a medical procedure used to remove kidney stones from the body when they cannot pass naturally. It is typically recommended when large kidney stones block more than one branch of the collecting system of the kidney (known as staghorn kidney stones), the stones are larger than 0.8 inches (2 centimeters) in diameter, large stones are in the tube connecting a kidney and the bladder (ureter), or other therapies have failed. PNL is performed under general anesthesia, and a specialized needle is inserted into a urine-collecting chamber of the kidney to start the procedure. The most common risks of PNL include bleeding, infection, injury to the kidney or other organs, and incomplete stone removal. Before the procedure, patients undergo several tests to check for infections or other issues, and they may be instructed to stop eating and drinking the night before the surgery.
How to prepare for Percutaneous Nephrolithotomy?
Before percutaneous nephrolithotomy, patients usually undergo several tests, including urine and blood tests to check for infection or other issues, and a CT scan to locate the kidney stones. Patients may be instructed to stop eating and drinking after midnight on the night before the procedure and inform their care team about all medications, vitamins, and dietary supplements they are taking. In some cases, patients may need to discontinue these medications before the surgery. The patient's surgeon may also prescribe antibiotics to reduce the risk of infection.
How is Percutaneous Nephrolithotomy conducted?
Percutaneous nephrolithotomy is a medical procedure used to remove large kidney stones that cannot pass naturally. The procedure involves creating a passageway from the skin on the back to the kidney and using specialized instruments to locate and remove the stones. The surgeon or radiologist guides the instruments through the passageway using X-ray, CT, or ultrasound images. A flexible tube (catheter) may be inserted into the kidneys to help with the procedure, and a tube (sheath) is placed along the path of the needle. The surgeon breaks up the stones and removes them using specialized instruments.
How are Percutaneous Nephrolithotomy results reported?
Percutaneous nephrolithotomy results are typically reported during a follow-up visit with the surgeon, which usually takes place 4 to 6 weeks after the procedure. During this visit, the surgeon will assess the patient's recovery, check for any complications, and review any further treatment or care that may be needed. If a nephrostomy tube was used for draining the kidney, it will be removed during this visit, and the patient will be monitored for any signs of bleeding or pain. Additionally, imaging tests such as ultrasound, X-ray, or CT scans may be performed to ensure that any remaining stones have been removed and that urine is draining properly from the kidney.
Understanding the report
Percutaneous nephrolithotomy results are interpreted through follow-up visits with the surgeon, imaging tests like ultrasound, X-ray, or CT scan, and monitoring the removal of the nephrostomy tube if one was placed during the procedure. These evaluations aim to ensure that all kidney stones have been removed, that urine is draining correctly from the kidney, and that there are no complications or signs of infection. The results are used to assess the success of the procedure and determine any further treatment or follow-up care that may be needed.