Percutaneous Nephrolithotomy

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.

Risks

  • 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.

Getting Ready

The week before your surgery:

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

  • 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.

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

  • You may need to have an EKG, blood tests, and urine tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

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:

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.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You have a fever.

  • You get a cold or the flu.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • 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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