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Percutaneous kidney procedures

Percutaneous nephrostomy; Percutaneous nephrostolithotomy; PCNL; Nephrolithotomy

Percutaneous (through the skin) urinary procedures help drain urine from your kidney and get rid of kidney stones.

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Description

A percutaneous nephrostomy is the placement of a small, flexible tube (catheter) through your skin into your kidney to drain your urine. It is inserted through your back or flank.

Percutaneous nephrostolithotomy (or nephrolithotomy) is the passing of a special medical instrument through your skin into your kidney. This is done to remove kidney stones.

Most kidney stones pass out of the body on their own through urine. When they do not, your health care provider may recommend these procedures.

During the procedure, you will lie on your stomach on a table. You will be given a shot of lidocaine. This is the same medicine your dentist uses to numb your mouth. The provider may give you medicines to help you relax and reduce pain.

If you have nephrostomy only:

If you have percutaneous nephrostolithotomy (or nephrolithotomy):

The place where the nephrostomy catheter was inserted is covered with a dressing. The catheter is connected to a drainage bag.

Why the Procedure Is Performed

Reasons to have a percutaneous nephrostomy or nephrostolithotomy are:

Risks

Percutaneous nephrostomy and nephrostolithotomy are generally safe. Ask your surgeon about these possible complications:

Before the Procedure

Tell your surgeon:

On the day of the surgery:

After the Procedure

You are taken to the recovery room. You may be able to eat soon if you do not have an upset stomach.

You may be able to go home within 24 hours. If there are problems, your doctor may keep you in the hospital longer.

The surgeon will take out the tubes if x-rays show that the kidney stones are gone and your kidney has healed. If stones are still there, you may have the same procedure again soon.

Outlook (Prognosis)

Percutaneous nephrostolithotomy or nephrolithotomy almost always helps ease the symptoms of kidney stones. Often, the surgeon is able to remove your kidney stones completely. You sometimes you need to have other procedures to get rid of the stones.

Most people who are treated for kidney stones need to make lifestyle changes so that their bodies do not make new kidney stones. These changes include avoiding certain foods and not taking certain vitamins. Some people also have to take medicines to keep new stones from forming.

Related Information

Lithotripsy
Cystinuria
Kidney stones
Bladder stones
Kidney stones - self-care
Kidney stones and lithotripsy - discharge
Percutaneous urinary procedures - discharge
Kidney stones - what to ask your doctor

References

Georgescu D, Jecu M, Geavlete PA, Geavlete B. Percutaneous nephrostomy. In: Geavlete PA, ed. Percutaneous Surgery of the Upper Urinary Tract. Cambridge, MA: Elsevier Academic Press; 2016:chap 8.

Matlaga BR, Krambeck AE. Surgical management of upper urinary tract calculi. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 94. 

Zagoria RJ, Dyer R, Brady C. Interventional genitourinary radiology. In: Zagoria RJ, Dyer R, Brady C, eds. Genitourinary Imaging: The Requisites. 3rd ed. Philadelphia, PA: Elsevier; 2016:chap 10.

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Review Date: 1/1/2023  

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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