Percutaneous Nephrolithotomy (PCNL) is a surgical procedure used to remove large kidney stones. It is recommended when stones are too large for other non-invasive procedures, such as Extracorporeal Shock Wave Lithotripsy (ESWL), or when other treatments have failed. PCNL is also used for stones that are located in difficult-to-reach areas of the kidney, or when the stones are causing kidney damage.

Unlike traditional surgery, PCNL is performed through a small incision made in the patient's back, which allows for minimal disruption and a faster recovery time. The procedure uses a nephroscope to directly view and remove the stones​.

While ESWL (Extracorporeal Shock Wave Lithotripsy) uses shock waves to break down kidney stones into smaller fragments, PCNL is a more invasive procedure that involves:

• Incision: A small incision is made in the patient's back near the kidney, allowing access for the nephroscope.
• Nephroscope: A tube-like instrument is used to visualize and remove the stones directly, which is especially useful for large stones or those that cannot be broken down by shock waves.
• Stone Removal: Unlike ESWL, where the fragments pass through the urinary tract, PCNL involves the direct removal of the stone via the nephroscope​.

PCNL is typically performed under general anesthesia. Here’s what you can expect during the procedure:

1. Incision: A small incision (about 1 cm) is made in the back to provide access to the kidney.
2. Nephroscope Insertion: A nephroscope, a thin tube with a camera, is inserted through the incision to visualize the kidney stone.
3. Stone Removal: Using specialized tools, the urologist will remove the stone either intact or after breaking it into smaller pieces, if necessary. In some cases, a laser or lithotripter may be used to break up larger stones before removal.
4. Post-Procedure Care: After the procedure, a small tube (a nephrostomy tube) may be placed to help drain any fluid from the kidney.

The procedure generally takes 3 to 4 hours and is performed in a surgical setting​.

As with any surgical procedure, PCNL carries some risks. These may include:

• Infection: There is a small risk of developing a urinary tract infection or sepsis.
• Kidney Damage: Although rare, damage to the kidney during the procedure can occur.
• Hemorrhage: Blood clots or bleeding at the site of surgery may occur.
• Pain and Discomfort: Post-operative pain can be expected but is usually manageable with pain medications.
• Incomplete Stone Removal: In some cases, stones may not be fully removed, requiring additional treatment​.

Patients are advised to follow post-operative care instructions carefully to minimize complications and promote healing.

After undergoing PCNL, patients may experience some temporary side effects, including:

• Pain and Discomfort: Pain in the lower abdomen and back is common, especially immediately following the procedure.
• Blood in the Urine: It is normal to see blood in the urine for a few days after PCNL.
• Frequent Urination: Some patients experience an increased need to urinate or a sense of urgency, which typically resolves after a few days.

Most patients can expect a shorter recovery time compared to open stone surgery, with many returning to normal activities within a week​.

At Z Urology, we offer Percutaneous Nephrolithotomy (PCNL) as an effective treatment for large or complex kidney stones. Here's why you should choose us:

• Expert Care: Our urologists have extensive experience in performing PCNL and other kidney stone treatments.
• Advanced Technology: We use the latest technology and minimally invasive techniques for optimal results.
• Personalized Treatment Plans: We tailor each treatment to meet your specific needs, ensuring the best outcome for your health and recovery.
• Compassionate Support: We understand that kidney stones can be painful and disruptive. Our team is committed to providing you with the support you need throughout the treatment process.