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Percutaneous urinary procedures

Definition

Percutaneous (through the skin) urinary procedures help drain urine from your bladder and get rid of kidney stones.

Alternative Names

Percutaneous nephrostomy; Percutaneous nephrostolithotomy; PCNL; Nephrolithotomy; Kidney stent placement; Uteric stent placement

Description

A percutaneous nephrostomy is the placement of a small, flexible rubber catheter (tube) through your skin into your kidney to drain your urine.

Percutaneous nephrostolithotomy (or nephrolithotomy) is the passing of a special medical instrument through your skin into your kidney. This is done to get rid of kidney stones.

Most stones will pass out of the body on their own through urine. But when they do not, your doctor may recommend these procedures.

You will lie on your stomach on a table. You will be given a shot of Lidocaine or Xylocaine (the same medicines your dentist uses to numb your mouth). Your doctor or nurse may give you drugs to help you relax and reduce your pain.

If you have nephrostomy only:

  • First your doctor will insert a needle into your skin. Then the nephrostomy catheter will be passed through the needle and into your kidney.
  • You may feel some pressure and discomfort when the catheter is inserted.
  • A special type of x-ray will be used to make sure the catheter is in the right place.

If you have percutaneous nephrostolithotomy (or nephrolithotomy):

  • The doctor makes a small incision (cut) on your back and passes a needle through the skin to your kidney.
  • Special instruments are then passed through the needle. Your doctor will use these to take out the stone or break it into pieces.
  • After the procedure, a tube is placed in the kidney (nephrostomy tube), and another tube, called a stent, is placed in the ureter to drain urine from your kidney. This allows your kidney to heal.

The place where the nephrostomy catheter was inserted will be covered with a dressing. The catheter itself will be connected to a drainage bag.

Risks

Percutaneous nephrostomy and nephrostolithotomy are generally safe. Ask your doctor about these possible complications.

  • Pieces of stone are left in your body. You may need more treatments.
  • There is bleeding around your kidney.
  • Your kidney(s) may not work as well, or they may stop working.
  • Pieces of the stone may block urine flow from your kidney. This may cause very bad pain or damage to the kidney.
  • Kidney infection may occur.

Review Date: 1/13/2009
Reviewed By: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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