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PCNL - Percutaneous Nephrolithotomy:
Urology And Urosurgery
PCNL - Percutaneous Nephrolithotomy India offers information on PCNL - Percutaneous Nephrolithotomy in India, PCNL - Percutaneous Nephrolithotomy cost India, PCNL - Percutaneous Nephrolithotomy hospital in India, Delhi, Mumbai, Chennai, Hyderabad & Bangalore, PCNL - Percutaneous Nephrolithotomy Surgeon in India


Percutaneous nephrolithotomy (PCNL) Key hole surgery for kidney stones

Percutaneous nephrolithotripsy (PCNL or PNL) is a minimally invasive endoscopic treatment for removing large kidney stones called staghorn stones or large or multiple stones impacted at the upper ureter.


What does the procedure involve?

Disintegration & extraction of kidney stones with a telescope placed into the kidney (see below) through a small puncture in the back. This usually includes cystoscopy and x-ray screening.


Who is a candidate for PCNL?

While PCNL can be used to treat stones in any location and of any size, it is often reserved for the largest and most complex stones:
What should I expect before the procedure?

If you are taking Aspirin or Clopidogrel on a regular basis, you must discuss this with your urologist because these drugs can cause increased bleeding after surgery. There may be a balance of risk where stopping them will reduce the chances of bleeding but this can result in increased clotting, which may also carry a risk to your health. This will, therefore, need careful discussion with regard to risks and benefits.

You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. An X-ray may be taken in advance of surgery to confirm the position of your stone(s).

You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

If you are admitted on the day before surgery, you will normally be given antibiotics into a vein to prevent any infection at the time surgery.

Please be sure to inform your Urologist in advance of your surgery if you have any of the following:
What happens during the procedure?


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Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure. You will usually be given injectable antibiotics before the procedure, after checking for any allergies.

The operation is usually carried out in a single stage. First, a small tube is inserted up the ureter into the kidney by means of a telescope passed into the bladder. You are then turned on to your face and a puncture track into the kidney is established, using X-ray guidance. Finally, a telescope is passed into the kidney and the stone(s) extracted or disintegrated with ultrasound (see below). A catheter is usually left in the bladder at the end of the procedure together with a drainage tube in the kidney.

It may be necessary to puncture the kidney at more than one site if you have many stones scattered throughout the kidney.


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What happens immediately after the procedure?

On the day after surgery, a further X-ray is normally performed to assess stone clearance. Occasionally, it may be necessary to perform an X-ray down the kidney drainage tube using contrast medium. If the X-ray is satisfactory, the tube in your kidney and the bladder catheter will be removed. There is often some leakage from the kidney tube site for 24-48 hours and you will be only discharged once this leakage has resolved.

The average hospital stay is 4-5 days.

The advantages of PNL or PCNL is:
What are the potential risks and complications?

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