Percutaneous Nephrolithotomy
A surgical treatment option for troublesome kidney stones so you can feel your best
As a national leader in kidney stone removal procedures, IU Health urologists provide the best care and treatment for your needs.
If you have large or complex kidney stones, our advanced percutaneous nephrolithotomy procedure can help get you back to enjoying your life stone-free.
Kidney stones are pieces of solid, crystallized matter that form in the kidneys. These stones develop when chemicals that are normal in the urine become concentrated. Kidney stones can be painful and interfere with your daily activities.
If you have found yourself with large, infected, or hard-to-reach kidney stones that will not pass on their own, your doctor may recommend percutaneous nephrolithotomy.
What is Percutaneous Nephrolithotomy?
Percutaneous nephrolithotomy is the most advanced kidney stone extraction option offered by IU Health urologists. It is used to remove larger or infected stones and is an option for patients with complicated bladders.
The minimally invasive surgical procedure consists of a urologist making a small incision in your back so a small tube can be inserted directly into your kidney. An ultrasonic wand pulses the stone and breaks it apart, then suctions the pieces out so no residual fragments are left behind.
Watch: What to Expect with a Percutaneous Nephrolithotomy
To ensure you are a good candidate for percutaneous nephrolithotomy, your care team will conduct pre-operative testing.
If necessary, you will be taken off blood thinner medications to prevent unnecessary bleeding during and after the surgery.
Preparing for Your Percutaneous Nephrolithotomy
To ensure you are a good candidate for percutaneous nephrolithotomy, your care team will conduct pre-operative testing.
If necessary, you will be taken off blood thinner medications to prevent unnecessary bleeding during and after the surgery.
Prior to your procedure, you will be placed under anesthesia to help you stay comfortable and safe during surgery.
Once you are asleep, your urologist will make a small incision in your back, directly into your kidney. A tube is then inserted into the incision to allow for small tools to access the stone. Once the kidney stone is located, an ultrasonic wand will break the stone apart.
Once the stone has been successfully broken down, your urologist may suction the pieces out during the procedure. In some cases, the pulverized stone can pass naturally out of your body in urine. To help the kidney heal and encourage the stone to pass, a stent is placed to hold the ureter open. The stent will then be removed a few days after all the stone fragments have passed.
Depending on the size and nature of your kidney stone, there is a small chance you may need a second procedure to ensure you are completely stone-free.
During Your Percutaneous Nephrolithotomy
Prior to your procedure, you will be placed under anesthesia to help you stay comfortable and safe during surgery.
Once you are asleep, your urologist will make a small incision in your back, directly into your kidney. A tube is then inserted into the incision to allow for small tools to access the stone. Once the kidney stone is located, an ultrasonic wand will break the stone apart.
Once the stone has been successfully broken down, your urologist may suction the pieces out during the procedure. In some cases, the pulverized stone can pass naturally out of your body in urine. To help the kidney heal and encourage the stone to pass, a stent is placed to hold the ureter open. The stent will then be removed a few days after all the stone fragments have passed.
Depending on the size and nature of your kidney stone, there is a small chance you may need a second procedure to ensure you are completely stone-free.
Once the procedure is complete, your doctor may order additional tests or procedures to ensure you are healthy, including:
- A CT scan to ensure the stones are gone or to check on the kidney
- A stent or nephrostomy tube to help drain the kidney
- Antibiotics, if your stone was infected
- A metabolic test to determine how the stones formed
Depending on your doctor’s assessment, you will either be sent home after your procedure or may have a one-night stay in the hospital before you are discharged.
As you recover, you will be asked to avoid heavy lifting or vigorous exertion for ten to fourteen days to allow your kidney to heal. After that, you may return to regular activities.
You may experience some blood in your urine and mild discomfort at your incision site during your recovery period. If you are concerned about any symptoms or pain management, please speak with your doctor after your procedure.
After Your Percutaneous Nephrolithotomy
Once the procedure is complete, your doctor may order additional tests or procedures to ensure you are healthy, including:
- A CT scan to ensure the stones are gone or to check on the kidney
- A stent or nephrostomy tube to help drain the kidney
- Antibiotics, if your stone was infected
- A metabolic test to determine how the stones formed
Depending on your doctor’s assessment, you will either be sent home after your procedure or may have a one-night stay in the hospital before you are discharged.
As you recover, you will be asked to avoid heavy lifting or vigorous exertion for ten to fourteen days to allow your kidney to heal. After that, you may return to regular activities.
You may experience some blood in your urine and mild discomfort at your incision site during your recovery period. If you are concerned about any symptoms or pain management, please speak with your doctor after your procedure.
