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Z Urology

Percutaneous Nephrolithotomy (PCNL)

What is Percutaneous Nephrolithotomy?

Percutaneous Nephrolithotomy is another form of lithotripsy. This procedure is required when either the stones are too large for other procedures, there were remaining stones after an extracorporeal shock wave lithotripsy, if the kidney stones are damaging the area where they are present or if you were not deemed an appropriate candidate for a lithotripsy that requires a ureteroscope.

How is it Different From a Lithotripsy?

This procedure is going to be performed under general anesthesia. There will be incisions made within the back to enter the kidney. Then, a nephroscope, similar to a ureteroscope, will be inserted through the incisions to grant the Urologist sight within the kidney. This tool possesses a larger tube than the ureteroscope. In this procedure, instead of breaking down the stones into smaller pieces for them to be transported out, the nephroscope removes them through a tube entirely. If the stones were first broken down through a nephrscope, then this is referred to as a Percutaneous Nephrolithotripsy.

The Procedure

This procedure is a minimally invasive procedure but it does need to be performed in a surgery center. This is not a procedure that can be performed in the office. At the surgery center, you will receive anesthesia and the doctor will ensure you are comfortable. 

Typically, the length of the surgery is three to four hours. The surgery is performed by making a small incision in the patient's back near the kidneys. A small telescope is then passed through the tube in order to visualize the stone, break it up and remove it from the body. If necessary a laser or other device called a lithotripter may be used to break up the stone before it can be removed. This procedure has resulted in significantly less post-operative pain, a shorter hospital stay, and an earlier return to work and daily activities when compared to open stone surgery. 

What to Expect After a Percutaneous Nephrolithotomy?

The effects of lithotripsy sometimes may be painful. You’re likely to see bleeding in your urine and pains in your lower abdomen. The best way to relieve pain is to drink large amounts of water and use some type of oral pain medication. If problems persist for more than a week such as continued bleeding, severe pain, or a strong feeling of needing to urinate, then contact your healthcare provider immediately. Although seldom, these kidney stones may cause bleeding near the kidney, a blockage within your urinary tract, or possibly severe damage where the stone was residing.

What are the Risks or Complications of PCNL?

All surgeries have risks, even minimally invasive procedures. Some risks of PCNL include:

  • Anesthesia risks.
  • Healing problems.
  • Infection.
  • Mass of clotted blood (hematoma).
  • Blood clots.
  • Fluid buildup at surgical sites (seroma).
  • Kidney damage.
  • Sepsis or a complicated urinary tract infection.
  • Inability to remove the kidney stone.

Contact a medical professional at Z Urology if you have any of the following symptoms,

  • Blood in the urine.
  • Painful or frequent urination.
  • Foul-smelling or cloudy urine.
  • Fever (if an infection is present.)

Patient Feedback for Z Urology

Our patients are the reason we strive for exceptional urological care and treatment! Here’s what some of our South Florida patients are saying about their experience at our clinics.
  • I have recommended many people to this office and each one has thanked me. On a scale of 1 to 5 (5 being the best), Dr. Z and his staff are a 12.
    – Alex S.
  • The wait was not long. I was greeted by a friendly nurse who took my sonogram of the kidneys and bladder. The doctor came in after a short time. Dr. Hollowell has a gentle voice and great bedside manner. He is very informative about my issues and I left feeling relieved and hopeful for future visits. The receptionists were also helpful and friendly. I recommend this office. Just wish it was closer to home.
    – Allison T.
  • "I found Doctor Varghese through my insurance provider network and read reviews in Healthgrades. Dr. Varghese is terrific. She explains things so they are easy to understand. I feel she is on top of several medical problems I’m having. I had a cystoscopy and was offered nitric oxide (mild gas). It was perfect. I have had the procedure in the past but it was the most uncomfortable feeling I ever experienced. Not this time. Doctor Varghese is an excellent listener and remembers what I tell her from the previous visits.

    Let me sum up my feelings about being under Dr. Varghese's care. I have new health insurance now so I can see doctors near my home, but instead I’ll continue to drive 75 miles each way to and from Pompano Beach to Stuart, FL [to see her].”
    – Jeffery P.
  • “I've been coming here for cancer for 10 years and I've had nothing but good visits every time. Staff is friendly and the doctors and PA'S are great. Dr. Z takes the time to ask questions and explain everything. He is amazing.”

    – Bill S.
  • “El Dr. Pedro Espino Grosso es un médico especialista en Urología es también especialista en entender, comprender y atender la preocupación de su paciente. Gracias por su profesionalismo como para todo el staff y las enfermeras por su amable y compasivo trato. Por favor no cambien!”
    – Ana L.
  • I have new health insurance now so I can see doctors near my home, but instead, I’ll continue to drive 75 miles each way to and from Pompano Beach to Stuart, FL to visit Z Urology!
    – Jeffery P.

  • “Dr. Mini Varghese of Z Urology is without a doubt the best Urologist in South Florida. She not only takes care of my father but now she's taking care of all my needs too. The team she has behind her at Z Urology is amazing, they go up and beyond their call of duty. A big shoutout to Z Urology in Pompano Beach, FL, thanks for keeping the pipes flowing...you gals are the Best!!!! Thanks Dr. Varghese.”
    – Brent S.
  • “Dr. Brar was awesome! He was very thorough with everything to ensure we got to the bottom of my issue! I felt like he cared and listened. I will be going back. The office was busy and some people were waiting a while but I was seen fairly quickly, I did fill out all the paperwork ahead of time so not sure if that helped! The person who helped me at the front desk was great and helped me with all my questions.”
    – Britney C.
  • Everyone seemed nice, friendly and welcoming. I was also impressed with the examination and the way the staff treated me. Dr. Mike took the time with me to listen and advise me as to what treatment plan might be needed.
    – Jimmy Z.
  • Great specialist, hard to find a more personable and efficient medical office anywhere else. I was welcome from the moment I came in, everyone was very friendly and all my questions and needs were expertly attended to. Never been to a urologist so this was new to me, but I definitely felt comfortable and heard. It was a drive from neighboring Miami but well worth it. Highly recommend. Thanks, Dr. Z!
    – Jose T.

  • Thank you Dr. Michael Zahalsky for the surgery, you changed my life completely. I'm so happy, now no more pain and I'm feeling better than ever, thanks again for the great staff in your office. Very professional. Felt like family.
    – Frank C.

  • They are very friendly. My surgeon went through the same procedure and read my mind of all my concerns. He reassured me everything would be okay and life would go on.
    – Jeremy C.


  • Three words: Kind, Caring and Compassionate! This office is the best of the best. The front desk employees are super friendly and the doctors are professional and spoke to me in a down-to-earth & making it easier for me to understand what was going on. I am able to make informed decisions with the material that was provided to me.
    – A.D.Z.



  • I had a great first visit with Dr. Z and his staff. I was seen within a reasonable amount of time. Dr. Z was personable and, after hearing my history and doing a targeted physical exam, directed his staff to perform ultrasound and bladder testing which was done efficiently and with discretion. Dr. Z then came in and spent a good amount of time explaining a clinical treatment plan. I left feeling I was in the hands of a total professional office from the top down.
    – Harvey A.




  • Z urology is the best and I have to say Dr. Zahalsky is extremely knowledgeable and such a humble and pleasant human being. I always feel welcome at Z Urology.
    – Kimaro W.





In Network with Most Insurance Plans


Our clinic accepts most major insurance plans and offers flexible financing options to ensure you receive the care you need. Our team will work with you to maximize your benefits and minimize out-of-pocket costs.
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Questions about insurance coverage?

Contact our office at (954) 714-8200. Additionally, we encourage you to call your insurance provider to confirm what your coverage includes.

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Whether you're experiencing urinary symptoms, dealing with a chronic condition, or need specialized treatment, Z Urology is your go-to care team. We provide the highest quality of care and truly value patient communication so you feel comfortable and informed every step of the way.

Contact Z Urology today to book an appointment and take the first step towards better urological health!
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