Open Nephrolithotomy

What you should know

Open nephrolithotomy is surgery to open your kidney to remove kidney stones.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may get an infection or bleed more than expected. You may also feel pain and weakness in your abdominal muscles. Your stomach, intestines, blood vessels, or nerves may be injured during the surgery. You could have trouble breathing. Even after surgery, kidney stones may form again. You may get a blood clot in your leg or arm. This may be life-threatening.

  • Without treatment, kidney stones can stop urine from properly draining from your kidney. This can cause an infection, kidney damage, or kidney failure. This can be life-threatening.

Getting Ready

The week before your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Dye may be used during your surgery to help caregivers see the kidney better. Tell your caregiver if you are allergic to contrast dye.

  • You may need to have blood and urine tests. You may also need an ultrasound and x-rays of the urinary tract, or a CT scan. Ask your caregiver about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

  • You may be given medicine to help you sleep.

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

General anesthesia will keep you asleep and free from pain during surgery. Your caregiver may inject dye and use an ultrasound to see parts of the kidney. An incision will be made in your side. Your caregiver will make an incision in your kidney and remove the stones. Your caregiver may also remove a small part of the kidney to help the urine drain better. He may remove the whole kidney if it is badly damaged by the stones. X-rays of the kidney will be taken to check if all stones have been removed. Thin tubes will be put near the kidney to drain fluid from your incisions. The incisions will be closed with stitches or surgical tape and covered with bandages.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be taken to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your wound or drains.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You have a fever.

  • You get a cold or the flu.

  • You have a skin infection or an infected wound on or near the area where surgery will be done.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • You have more pain or trouble passing urine.

  • Your symptoms get worse.

© 2014 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 A.D.A.M., Inc. 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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