Open Nephrolithotomy

WHAT YOU SHOULD KNOW:

  • Open nephrolithotomy (nef-ro-li-THOT-o-me) is surgery to completely remove kidney stones. Kidney stones are rock-like pieces or crystals formed from the urine. These may cause pain, infection, bleeding, and damage to the kidneys. Kidney stones usually form in the kidneys but may also be found in other parts of the urinary tract. The kidneys are two bean-shaped organs located in the back of the abdomen (stomach), at both sides of the spine. They remove unwanted chemicals and waste from the blood in the form of urine. The urine flows from both kidneys through tubes called ureters. The bladder is a hollow, round organ that holds urine. Urine leaves the bladder and goes out of the body through another tube called the urethra.
    Urinary System


  • Open nephrolithotomy may be done to take out large stones or when other procedures have not worked. This may also be done for people who are obese (very overweight) or those with other health problems. During this surgery, an incision (cut) is made in the flank (side of the abdomen) area. This is done so the affected kidney and many structures lying close to it can be fully seen. The kidney is then opened and the stones are removed. With open nephrolithotomy, symptoms may be treated and more serious health problems prevented.

INSTRUCTIONS:

Medicines:

  • Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

  • Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

  • Ask your caregiver when you should return to have your wound checked, drain taken out, and stitches removed.

Bathing with stitches:

Follow your primary healthcare provider's instructions on when you can bathe. Gently wash the part of your body that has the stitches. Do not rub on the stitches to dry your skin. Pat the area gently with a towel. When the area is dry, put on a clean, new bandage as directed.

  • Always check your drain when changing your bandages. Do not pull out your drain. Ask your caregivers for more information about drain care.

Bladder care:

  • Catheter: You may need to learn how to insert a catheter by yourself if you cannot urinate on your own. A catheter is a soft rubber tube that you put into your urethra to drain your urine. You may also need a bladder irrigation. Medicines or special solutions may be put inside your bladder through your catheter. Ask your caregiver for more information on self-catheterization and bladder irrigation.

  • Voiding: Do not let your bladder become too full before emptying it. Set regular times each day to urinate. Urinate as soon as you feel the need. Ask your caregiver if you need to strain your urine to look for any pieces of kidney stones. You may use a special strainer to strain your urine.

Diet and drinking liquids:

  • Eat a variety of healthy foods such as fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat and fish. Eating healthy foods may help you have more energy and heal faster. Ask your caregiver if you need to be on a special diet.

  • Drink about 3 to 4 Liters of liquid each day (around 13 to 17 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, good liquids to drink are water, juices, and milk. Try to drink enough liquid each day, and not just when you feel thirsty.

Learn ways to manage stress. Deep breathing, meditation, and listening to music may help you cope with stressful events. Talk to your caregiver about other ways to manage stress.

Rest when you need to while you heal after surgery.

Slowly start to do more each day. Return to your daily activities as directed.

CONTACT A CAREGIVER IF:

  • You have a fever.

  • You have chills, a cough, or feel weak and achy.

  • You have dizziness, nausea (upset stomach), or vomiting (throwing up).

  • Your skin is itchy, swollen, or has a rash.

  • You have chest pain or trouble breathing that is getting worse over time.

  • You have questions or concerns about your surgery, condition, or care.

SEEK CARE IMMEDIATELY IF:

  • You have pain in your abdomen, flank, or genital area that does not go away or gets worse.

  • You have problems passing urine or having a bowel movement.

  • You have pus or a foul-smelling odor coming from your incision.

  • Your bandage becomes soaked with blood.

  • Your symptoms become worse or come back.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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