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Percutaneous Nephrolithotomy or Nephrolithotripsy

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Procedure

Percutaneous Nephrolithotomy or Nephrolithotripsy

Definition

Percutaneous nephrolithotomy or nephrolithotripsy removes stones from the kidney through a small cut in the skin.

Nephrolithotomy is the removal of an intact stone.

Nephrolithotripsy is the removal of a stone that had been broken apart with other treatments, such as high frequency sound waves.

Kidney Stone.

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Reasons for Procedure

Some kidney stones can cause injury to the urinary tract or block the flow of urine. That can lead to kidney damage and serious illness. Percutaneous nephrolithotomy and nephrolithotripsy can help to remove the stone and lower the risk of damage. It may be chosen when:

  • Other methods are not possible or were not able to break up the kidney stones
  • Kidney stones are large or have an odd shape
  • An infection is present

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing and sore throat
  • Infection
  • Blood clots
  • Blockage of the tube (ureter) that carries urine from the kidney to the bladder
  • Injury to nearby structures
  • Remaining stone fragments
  • Kidney stones return

Things that may raise the risk of problems are:

  • Smoking
  • Drinking excess alcohol
  • Chronic diseases, such as diabetes or obesity

What to Expect

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excess bleeding, or discharge from the wound
  • Pain that you cannot control with medicine
  • Problems passing urine
  • Bloody urine that lasts longer than you or your doctor expect
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Planning for a ride to and from surgery
RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Kidney stones. Urology Care Foundation website. Available at: https://www.urologyhealth.org/urology-a-z/k/kidney-stones.
  • Nephrolithiasis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/nephrolithiasis-in-adults-24.
  • Percutaneous nephrolithotomy (PCNL). University of Florida Department of Urology website. Available at: https://urology.ufl.edu/patient-care/stone-disease/procedures/percutaneous-nephrolithotomy-pcnl.
  • Percutaneous nephrolithotomy/nephrolithotripsy. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/kidneystones_PNN.

Contributors

  • Mark S. Itzkowitz, MD, JD
Last Updated:
2022-09-01

(C) Copyright 2023 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.