Percutaneous Nephrolithotomy

PCNL stands for percutaneous nephrolithotomy, a surgical procedure to remove kidney stones that are too large or complex to pass on their own or be treated with other less invasive methods. "Percutaneous" means through the skin, and "nephrolithotomy" refers to the removal of a kidney stone. 

Here's a more detailed explanation:

• When it's used:
  PCNL is typically recommended when other procedures like shockwave lithotripsy or ureteroscopy are not suitable or have been unsuccessful. 

• How it's done:
  A small incision is made in the back, and a thin tube is inserted to access the kidney. A scope and specialized instruments are then used to locate, fragment, and remove the stones. 

• Benefits:
  PCNL can be effective in removing large or complex stones, even those that are difficult to reach from other angles. 

• Risks:
  Like any surgery, PCNL carries risks, including bleeding, infection, and potential injury to nearby organs. 

• Recovery:
  The procedure usually requires a hospital stay of one to two nights, and most patients can return to normal activities within one to two weeks. 

WHAT TO EXPECT AFTER YOUR MINI-PCNL:

1. Blood in the urine: this is common and usually not a sign of anything concerning. If you have a ureteric stent, you may have blood off and on until the stent is removed. Drink lots of water (2-3L per day) to keep the urine clear.

2. Back pain: pain at the site of incision. This will typically get much better within 48 hours but may continue to some degree if you have a ureteric stent. This pain will resolve totally once the stent is removed. You can take Tylenol as needed, and Dr. Langley will provide you with a prescription for additional pain control, if needed.

3. Sensation of urinary urgency/"needing to pee all the time": this is common and mostly due to your stent. This will resolve once the stent is removed. You may also feel pressure in the lower abdomen. Dr. Langley will provide medication to help with this discomfort.

4. Leakage of urine through the back incision: this is normal and expected. This may necessitate frequent dressing changes until the leakage stops. This will typically slow down within 24-48hours and should resolve by 5-7 days (usually earlier).

OTHER INSTRUCTIONS: 1. Drink lots of water (2-3 L per day) 2. Do not lift anything heavier than 10 lbs. for 2 weeks 3. You may remove your dressing in 48 hours 4. Unless otherwise specified, you can restart any blood thinners in 7 (seven) days

WHEN TO SEEK MEDICAL ATTENTION: 1. If you develop any fevers (Temperature over 38C) or chills. 2. If you have large clots in the urine (i.e. the size of a Looney, or larger). 3. If you have significant back pain that does not resolve with Tylenol, anti-inflammatories, or narcotics 4. If you feel faint/unwell *If you meet any of the above criteria, then go directly to the ER. Please inform our office as well.