Percutaneous nephrolithotripsy

Diagram of PCNL

Percutaneous stone surgery is usually used for larger stones. A small hollow tube is placed directly through a patient’s back into the kidney through which larger instruments can then be used to fragment and extract the stone(s). Although this approach typically requires a hospital stay and is more invasive than ureteroscopy or extracorporeal shockwave lithotripsy, it is often the most effective method for treating  large stones quickly and completely. For more information on comparing the surgical options for kidney stones, see our comparison chart.

Percutaneous stone surgery may also be indicated in certain situations where the ureter below a  kidney is obstructed, such as in ureteropelvic junction obstructions, where a ureteroscope cannot be advanced from below.

Fast facts about percutaneous nephrolithotripsy:

  • Typical operative time: 1-2 hours
  • Usual hospital stay: 1-2 days
  • Average number of days before going back to work: about one week
  • Average number of days before feeling back to normal: about two weeks

PCNL instruments photo

A photograph showing a nephroscope used for percutaneous nephrolithotripsy. The gray tube around the instrument is the sheath placed temporarily into a kidney to allow access. A pen is shown for size comparison.

 

 

Video of percutaneous nephrolithotripsy procedure.

 

 

Video of percutaneous nephrolithotripsy procedure of a soft matrix stone. This type of stone is rare and primarily composed of  soft tissue elements. It is usually associated with infection.

9 Responses to Percutaneous nephrolithotripsy

  1. Joanne Gillen says:

    After 10 weeks of antibiotics,I’ve been told yesterdày I hav a huge staghorn kidney stone ( 10 cm ) omg,doc says 3 to 4 hours in theatre,5 day stay in hospital has anyone had a stone of this size removed ????

    • jane westerman says:

      Hi
      I have just been diagnosed last week as having a huge staghorn stone too, although he didn’t give me the exact measurements. I too have to be admitted to hospital he also told me about 3 hour operation but only told me I would probably be in hospital from about 3 days. I am sorry I haven’t any experience to tell you about it, as in the same boat, but would be grateful too for any information at all. It is a PCNL operation he has recommended. Also I am wondering how long we will wait for the operation, as I have been suffering for years with pain (got told nothing wrong with me just muscular) and just diagnosed this last week currently been on sick from work as pain is unbearable. So the sooner the better for me. Good luck for your operation xxx

      • Kathy says:

        Hi Jane!

        Was wondering if you had your surgery yet? I just got out of hospital (just an overnight) yesterday after having a minimally invasive PCNL for 2×1 cm staghorn stone in right kidney, and utereroscopy on left for two other stones. My story sounds very similar to yours – misdiagnosed for years (not that I didn’t complain!). I had bilateral stents placed also. Incision from PCNL is only 1 cm. They removed the tube when I was discharged and waterproof bandaged it. Incision tends to leak the first couple of days after tube removal. Will not even need it rebandaged if it’s not leaking tomorrow. The nurses kept me very comfortable with pain medication in the hospital. Can honestly say, after pain and infection of stones, the surgery was very bearable. Was walking the hospital floor that night. Am planning on stopping narcotics today. Discomfort from the stents is worse than the incision area – kind of spasms/burning when I urinate- which is frequently. I do tire easily and rest a lot, but can putter around the house for a few hours at a time. Can definitely tell if I am overdoing it. I didn’t know what to expect, but it was much easier than I imagined. Doctor told me two weeks to feel “normal”. Can’t drive for a week or lift anything heavy, but can do almost anything else that is not too strenuous. Already feel better. Don’t know if you are having the minimally invasive type of PCNL, but hope my experience helps you. Good Luck. Know you will ultimately feel MUCH better! The anticipation prior to the surgery was the worst part along with the prepping/clear liquid diet.

  2. Katie says:

    I have been advised two different types of treatment from two different urologist and am unsure of which is best.

    1- remove kidney

    2- PCNL

    My right kidney is dramatically smaller than my left. The right kidney function is 17% with a complete stag horn stone 4cm+. The left is healthy except for a 1cm stone inside the kidney tissue.

    They have advised the PCNL will take 3 different surgeries to complete. Which sounds a bit daunting.

    Any insight would be greatly appreciated. Thank you!

  3. Geedee says:

    Hi can anyone share with me recovery time after a PCNL (hopefully please without a second stent !) I read it is 3 or so days in hospital a week recovery and full recovered in two weeks … I’m due a pcnl on 4th June, is it safe to go on holiday (Europe flight) 16th?? Any views appreciated. Ps had this stent for 7 weeks no respite from pain ! And now peeing random blood clots !

    • maryann ferns says:

      I’ve had numerous stents over the last 35 years and my best advise for stent discomfort is to keep something in the bladder. Always be drinking something. In an empty bladder the stent ends rub the walls of the bladder but having liquid in there causes them to float freely.good luck.

  4. Pingback: Kidney Stones During Pregnancy | KidneyStoners.org

  5. Sudhir kute says:

    I hv ben operated under pcnl kideny stone peocedure on 2/5/13. While surgery two times incision done on my back.
    Still today fluid is continue frm my back.
    I want to know why this happens
    Req suggestion
    Regards
    Sudhir kute

    • jane says:

      My very first kidney stone procedure was the Perctaneous one and nothing went to plan to what the leaflet said.My stone was a massive staghorn that filled my kidney and took over 4 hrs to be told they had removed 90% .My stay in hospital ended up being 6 days not 2 ..I didn’t have a clue what was going on and traumatized isn’t the word. When finally removed the tube from my kidney I didn’t know it was like a little umbrella that opened and closed and and that the nurse taking it out couldn’t close it as there was a stone in it preventing it so you can imagine the pain when she pulled it out still open! I was told to get dressed and when I did I felt warm liquid flood out my incision and panicked and pressed my buzzer for the nurse. She calmly said “oh that’s your wee because it will go to the nearest hole so I,ll just get you a stomer bag!!! WTF???? No one told me I,d need one of these or that I,d be using them at home for 9 days until my incision closed??? Trying to empty them when they are behind well..hard..thats an understatement. I had to get my son to help when he was there or if on my own empty them into my bathroom sink and bleach after as they are so high up you had to be a contortionist to attempt without spilling it all over. I hope no one ever has to endure what I went through and to this day I still suffer from kidney stones and have yearly ops to try and remove them but they keep on coming back!

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