Percutaneous Nephrostolithotomy (PCNL)

This procedure is reserved for large, often branched stones of the kidney. A nephrostomy tube is placed through the flank into the kidney. While under anesthesia, the nephrostomy track is dilated, exchanging the small nephrosotomy tube for a larger sheath placed from the flank into the kidney. A nephroscope can be passed down the sheath. Various instruments can be passed through the nephroscope to pulverize and retrieve pieces of the stone. The case concludes by placing a drainage tube from the kidney out the small flank incision. This is removed when post-op imaging shows good healing and no residual stones. Some urologists are not using any external tubes, preferring an internal ureteral stent. Consult with your urologist about your individual case to decide whether you need a drainage tube and where it may be placed.