Percutaneous Nephrolithotomy and Percutaneous Nephrolithotripsy

Kidney stone treatment varies per patient and stone formation. If the stone is small, about 4mm in diameter or less, treating it can be done at home. Stones of that size, or smaller, can be passed in the urine naturally with large fluid intake and pain medication. Conversely, stones that are the size of more than 5mm in diameter may require other forms of medical treatment.

Treating large kidney stones may involve both non-invasive and invasive techniques. The most common is shock wave lithotripsy and ureteroscopy for stones of up to 2cm and 15mm in diameter, respectively. For larger ones, percutaneous nephrolithotomy or percutaneous nephrolithotripsy may be required to remove the stones successfully.

Percutaneous Nephrolithotomy / Nephrolithotripsy

The procedure is basically the same for both percutaneous nephrolithotomy and percutaneous nephrolithotripsy. The term, percutaneous, means through the skin, which implies an invasive surgery procedure. The process involves making a small in the back to gain access to the kidney. A nephroscope, which is a small fibreoptic camera, is then inserted through the hole along with other instruments.

The difference between nephrolithotomy and nephrolithotripsy is the process of removing the stones from the kidneys. When the stone is removed from the kidney through the tube, it is called nephrolithotomy. Alternatively, when the stone is broken up first with high-frequency sound waves before suctioning the ‘dust’, it is called nephrolithotripsy.

When to have Percutaneous Nephrolithotomy/ Nephrolithotripsy?

The procedure is only done when common treatments as Shock Wave Lithotripsy and Ureteroscopy cannot be done to treat the kidney stones. Certain health conditions must be met before said common treatment options can be considered. When a patient is pregnant, has blood clotting problems, has weak kidneys, has infections or has very large stones, percutaneous nephrolithotomy/ nephrolithotripsy may be needed.

What to expect after the procedure?

The treatment requires general anesthesia as it is an invasive technique. Hospitalization can take up to three days and then another week or so of recovery at home. You should not return to work or drive until your doctor approves.

Percutaneous nephrolithotomy or nephrolithotripsy are invasive techniques and are effective at removing stones completely from the kidneys. Many patients return home stone-free after one operation, but a small number of cases require other treatments afterwards. Discuss with your surgeon your options and the risks involved with this procedure.

With the medical and technological advancements available these days, kidney stone treatments have become more effective and less invasive. While open surgery is still a possibility, it is rarely ever used in treating kidney stones as less invasive procedures, like percutaneous nephrolithotomy and nephrolithotripsy have proven to be effective.

If you are in need of more help, there are many kidney stone treatments available.

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