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WHAT YOU SHOULD KNOW:
Percutaneous nephrolithotomy is surgery to remove kidney stones using a scope.
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.
- You may get an infection or bleed more than expected. You could have trouble breathing. Organs such as the liver, lungs, and spleen could be damaged during surgery. Scars may form where the stone was removed. Caregivers may not be able to remove your kidney stone, and you may need another surgery. 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.
WHILE YOU ARE HERE:
Before your surgery:
- Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
- An IV is a small tube placed in your vein that is used to give you medicine or liquids.
- A KUB x-ray takes pictures of your kidneys, ureters, and bladder. Your caregivers use these pictures to see where the kidney stone is located.
- General anesthesia will keep you asleep and free from pain during surgery. You may be given anesthesia through your IV. You may breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
During your surgery:
An incision will be made in your back. A nephroscope will be put through the incision and into your kidney near the stone. The nephroscope is a long tube with a magnifying glass and a light on the end. Caregivers may use x-rays or an ultrasound to help guide the scope. The nephroscope and other tools will be used to gently remove the stone. A machine such as a lithotriptor or an ultrasound may be used to break the stones into smaller pieces. The stone will be sent to the lab for tests. The incision will be closed with stitches or surgical tape.
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. Your incision will be covered by a bandage. This bandage keeps the area clean and dry to help prevent infection. It is normal for urine to leak out of the incision for a few days after surgery. A caregiver may remove the dressing soon after surgery to check the incision.
- You may need to walk around the same day of surgery , or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.
- Deep breathing and coughing will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath. Then let the air out and cough. Repeat these steps 10 times every hour.
- You will be able to eat and drink gradually after surgery. You will begin with ice chips or clear liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then eat soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.
- Intake and output of liquids may need to be tracked. Your caregivers may need to track the amount of liquid you are getting. They may also need to know how much you are urinating. Caregivers may need to strain your urine to check for stones. Do not flush your urine down the toilet unless caregivers say it is okay.
- Antibiotics help treat or prevent an infection.
- Antinausea medicine calms your stomach and prevents vomiting.
- Pain medicine will decrease your pain. Do not wait until the pain is severe to ask for your medicine. Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
- Antibiotics help treat or prevent an infection.
- You may need to wear pressure stockings or inflatable boots after surgery. The stockings are tight and put pressure on your legs. The boots have an air pump that tightens and loosens different areas of the boots. Both of these improve blood flow and help prevent clots.
- A ureteral stent is a small tube that is placed inside your ureter. The ureters take urine from your kidneys to your bladder. Your stent may come through your skin and be connected to a urine collection bag. The stent helps urine and pieces of kidney stone pass out of your body.
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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.