Percutaneous kidney procedures
Percutaneous (through the skin) urinary procedures help drain urine from your kidney and get rid of kidney stones.
Percutaneous nephrostomy; Percutaneous nephrostolithotomy; PCNL; Nephrolithotomy
A percutaneous nephrostomy is the placement of a small, flexible rubber tube (catheter) through your skin into your kidney to drain your urine. It is inserted through your back or flank.
Percutaneous nephrostolithotomy (or nephrolithotomy) is the passing of a special medical instrument through your skin into your kidney. This is done to remove kidney stones.
Most stones pass out of the body on their own through urine. When they do not, your health care provider may recommend these procedures.
During the procedure, you lie on your stomach on a table. You are given a shot of lidocaine. This is the same medicine your dentist uses to numb your mouth. The provider may give you medicines to help you relax and reduce pain.
If you have nephrostomy only:
If you have percutaneous nephrostolithotomy (or nephrolithotomy):
The place where the nephrostomy catheter was inserted is covered with a dressing. The catheter is connected to a drainage bag.
Why the Procedure Is Performed
Reasons to have a percutaneous nephrostomy or nephrostolithotomy are:
Percutaneous nephrostomy and nephrostolithotomy are generally safe. Ask your doctor about these possible complications:
Before the Procedure
Tell your provider:
On the day of the surgery:
After the Procedure
You are taken to the recovery room. You may be able to eat soon if you do not have an upset stomach.
You may be able to go home within 24 hours. If there are problems, your doctor may keep you in the hospital longer.
The doctor will take out the tubes if x-rays show that the kidney stones are gone and your kidney has healed. If stones are still there, you may have the same procedure again soon.
Percutaneous nephrostolithotomy or nephrolithotomy almost always helps ease the symptoms of kidney stones. Often, the doctor is able to remove your kidney stones completely. You sometimes you need to have other procedures to get rid of the stones.
Most people who are treated for kidney stones need to make lifestyle changes so that their bodies do not make new kidney stones. These changes include avoiding certain foods and not taking certain vitamins. Some people also have to take medicines to keep new stones from forming.
Georgescu D, Jecu M, Geavlete PA, Geavlete B. Percutaneous nephrostomy. In: Geavlete PA, ed. Percutaneous Surgery of the Upper Urinary Tract. Cambridge, MA: Elsevier Academic Press; 2016:chap 8.
Matlaga BR, Krambeck AE, Lingeman JE. Surgical management of upper urinary tract calculi. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 54.
Zagoria RJ, Dyer R, Brady C. Interventional genitourinary radiology. In: Zagoria RJ, Dyer R, Brady C, eds. Genitourinary Imaging: The Requisites. 3rd ed. Philadelphia, PA: Elsevier; 2016:chap 10.
Review Date: 1/31/2019
Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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