Percutaneous (through the skin) urinary procedures help drain urine from your bladder and get rid of kidney stones.
A percutaneous nephrostomy is the placement of a small, flexible rubber catheter (tube) through your skin into your kidney to drain your urine.
Percutaneous nephrostolithotomy (or nephrolithotomy) is the passing of a special medical instrument through your skin into your kidney. This is done to get rid of kidney stones.
Most stones will pass out of the body on their own through urine. But when they do not, your doctor may recommend these procedures.
You will lie on your stomach on a table. You will be given a shot of Lidocaine or Xylocaine (the same medicines your dentist uses to numb your mouth). Your doctor or nurse may give you drugs to help you relax and reduce your pain.
If you have nephrostomy only:
If you have percutaneous nephrostolithotomy (or nephrolithotomy):
The place where the nephrostomy catheter was inserted will be covered with a dressing. The catheter itself will be connected to a drainage bag.
Reasons to have a percutaneous nephrostomy or nephrostolithotomy are:
Percutaneous nephrostomy and nephrostolithotomy are generally safe. Ask your doctor about these possible complications.
Always tell your doctor or nurse:
On the day of the surgery:
You will be 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 doctor 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.
Percutaneous nephrostolithotomy or nephrolithotomy will almost always help ease the symptoms of kidney stones. Often, your doctor is able to get rid of your kidney stones completely. But sometimes you will 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.
Percutaneous nephrostomy; Percutaneous nephrostolithotomy; PCNL; Nephrolithotomy
Lingeman JE, Matlaga BR, Evan AP. Surgical management of upper urinary tract calculi. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders; 2007:chap 44.
Wen CC, Nakada SY. Treatment selection and outcomes: renal calculi. Urol Clin North Am. 2007;34(3):409-419.
Updated by: Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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