Percutaneous Nephrolithotomy or Nephrolithotripsy for Kidney Stones
Treatment Overview
In percutaneous nephrolithotomy or
nephrolithotripsy, the surgeon makes a small incision in your back to remove
kidney stones. He or she then puts a hollow tube into
your kidney and a probe through the tube. In nephrolithotomy, the surgeon
removes the stone through the tube. In nephrolithotripsy, he or she breaks the
stone up and then removes the fragments of the stone through the tube.
See a picture of
nephrolithotomy.
You need either
general anesthesia or
regional or spinal anesthesia during this procedure. A
small tube (catheter) may be inserted into the kidney to drain urine until the
kidney heals.
What To Expect After Treatment
You will be in the hospital for at
least 2 to 3 days. Most people are able to return to work within a few
weeks.
Why It Is Done
This procedure may be used to treat
kidney stones that are:
- Larger than
2 cm (0.8 in.) in
diameter.
- Large and caused by an infection (staghorn calculi).
- Blocking the flow of urine out of the
kidney.
- Not broken up by extracorporeal shock wave lithotripsy
(ESWL).
How Well It Works
Percutaneous nephrolithotomy or
nephrolithotripsy successfully removes stones in the kidney about 95 times out
of 100 and successfully removes stones in the
ureter about 88 times out of 100.1
Risks
Risks of this procedure include:
- Bleeding.
- Holes (perforation) in
the kidney. They usually heal without further treatment.
- Injury to
other abdominal organs, such as the
bladder or
colon.
- Damage that affects normal kidney
function.
What To Think About
A stone that has left the kidney may need to be pushed
back into the kidney with a small tool (ureteroscope) before the surgeon can do
the procedure.
These procedures are used more frequently than
extracorporeal shock wave lithotripsy (ESWL) to remove larger stones, such as
staghorn calculi. Every fragment of a staghorn calculus must be removed to
prevent the stone from returning.
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
References
Citations
-
Spector DA (2007). Urinary stones. In NH Fiebach et
al., eds., Principles of Ambulatory Medicine, 7th ed.,
pp. 754–766. Philadelphia: Lippincott Williams and Wilkins.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Anne C. Poinier, MD - Internal Medicine |
|
Specialist Medical Reviewer
|
Tushar J. Vachharajani, MD, FASN, FACP - Nephrology |
|
Last Revised
|
April 28, 2011 |
Last Revised:
April 28, 2011
Spector DA (2007). Urinary stones. In NH Fiebach et
al., eds., Principles of Ambulatory Medicine, 7th ed.,
pp. 754–766. Philadelphia: Lippincott Williams and Wilkins.
