Percutaneous Nephrostolithotomy (PCNL)

Percutaneous Nephrostolithotomy is a procedure performed to remove large stones in the kidney or ureter. There are two parts to the operation. The first involves looking in your bladder with a scope and placing a small catheter into your kidney. This allows your urologist to find the correct spot in which to access the kidney in order to remove your stones. The second part involves placing a small tube directly into the kidney through the flank. A combination ultrasound and suction device is used to remove the stones. A flexible scope is used in some cases to look at all the areas of your kidney and remove any remaining stones. At times, additional accesses into the kidney may be required to remove all of the stones. At the end of the procedure a small drainage tube is placed into the kidney. It generally remains for 2-7 days at the discretion of your urologist. You may be sent home with the tube in your kidney, but will be instructed on care of it prior to your discharged. You will have a catheter in the bladder the first night. A one to three day hospital stay is generally required. X-rays are checked after surgery to evaluate if all of the stones were removed. You will be able to eat and drink afterwards and discomfort is generally mild.

What to expect afterwards:

Blood in both the kidney tube and your urine is normal for a few days to a few weeks. After the kidney tube is removed, it is common to have flank drainage for 2-5 days. If it lasts longer call your doctor.   Pain is generally mild but you will have both IV and oral pain medications available.

Call your doctor if:

  • Temperature >101° F.
  • Inability to void.
  • You are passing clots in your urine.
  • Flank drainage for more than five days after the kidney tube is removed.