Dr. Greenberger, urologist in Orange County California, is an expert at this procedure for treatment of large kidney stones. Over 90% of patients can expect to leave the hospital stone free after a PCNL.
Percutaneous Nephrolithotomy (also known as PCNL, PNL, and percutaneous nephrolithotripsy) is the most effective treatment for large kidney stones, staghorn calculi, cystine stones, kidneys with multiple stones, and stones associated with UPJ obstruction ( a type of kidney outlet obstruction). It is also used for patients who have tried lithotripsy but still have a large stone burden. At Associated Urologists of Orange County, large kidney stone treatment includes this important, and often best or most effective treatment option.
PCNL has been proven to be more successful and less expensive than ESWL (lithotripsy) for stones larger than 2 cm. ESWL for large kidney stones often requires multiple rounds of lithotripsy, each requiring time off work and several weeks to pass fragments before the next round of treatment. For this reason, even though PCNL requires an overnight hospital admission, the total time off work and recover is less than ESWL for treatment of these large renal stones. Therefore, it is considered the best treatment for large kidney stones.
You will be taken to the operating room. General anesthesia will be given. X-ray equipment will be used to guide a small needle into your kidney, and a guide wire can be placed into the kidney through the needle. Larger tubes are passed over the wire, creating a path between the skin and the part of the kidney next to the stone. Dr. Greenberger is then able to pass a nephroscope ( a minimally invasive instrument similar to the ones used for laparoscopic and arthroscopic surgery). At the end of the procedure, a narrow plastic tube, called a ureteral stent, will be placed in the ureter, which is the tube inside your body that drains urine from the kidney to the bladder. This helps drainage of urine from the kidney while you recover from your procedure. Rarely, a small tube is left in the kidney and out the small access incision in your back. This is generally removed the next day if there are no complications and all the stone has been removed.
