What is PCNL Surgery?          Expertise of Dr. Yasir Iqbal

Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure used to remove large or complex kidney stones that cannot be treated effectively with other less invasive methods. It is especially recommended for stones larger than 2 centimeters or for multiple stones located within the kidney.

How is PCNL Performed?

• The procedure is done under general anaesthesia.

• A small incision (about 1 cm) is made in the patient's back to create a direct channel into the kidney.

• Using specialized instruments, including a thin tube called a nephroscope, the surgeon locates and breaks the stones into smaller pieces.

• The fragments are then removed through the small incision.

• Sometimes, a stent or tube may be placed temporarily to help urine drain and assist with healing.

Advantages of PCNL

• Highly effective for large or complicated kidney stones.

• Minimally invasive compared to open surgery.

• Shorter recovery time and less postoperative pain.

• Can remove stones in a single session that might require multiple treatments otherwise.

When is PCNL Recommended?

• For large kidney stones (typically over 2 cm).

• When stones cause obstruction, infection, or severe pain.

• If other treatments such as shockwave lithotripsy or ureteroscopy are not suitable or have failed.

• For complex or multiple stones located in difficult-to-reach areas of the kidney.

Preparation for PCNL Surgery

Before surgery, your doctor will provide instructions, including:

• Medication review: Certain medications like blood thinners may need to be stopped before surgery.

• Fasting: Avoid food and drinks for at least 6-8 hours before the procedure.

• Preoperative tests: Blood tests, urine tests, imaging scans (CT or ultrasound) will be done.

• Discuss allergies and medical conditions: Inform your doctor about any allergies or existing health issues.

Recovery After PCNL

• Most patients stay in the hospital for 1 to 3 days after the surgery.

• Mild discomfort or soreness near the incision is common initially.

• Patients are encouraged to drink plenty of fluids to flush out any remaining stone fragments.

• Follow-up imaging may be done to confirm that all stones have been cleared.

• A nephrostomy tube (a drainage tube coming from your back) may be left in place temporarily to help the kidney drain urine and promote healing.

• It is usually removed before you’re discharged or within a few days afterward.

• Mild back or flank discomfort is normal and can be managed with prescribed pain medications.

• Any severe or persistent pain should be reported to your doctor.