Percutaneous Nephrolithotomy (PNL)
Percutaneous nephrolithotomy (PNL) effectively treats larger stones that cannot be removed using Shock Wave Lithotripsy or ureteroscopy. The urologist makes a small incision about one centimeter wide in the flank and uses radiologic guidance to thread a wire from the kidney down into the ureter.
A nephroscope is then passed into the kidney to visualize the stone and a laser is used to break the stone into fragments. Because a tract has been created by the wire, the urologist can suction or remove the fragments. Usually, a tube is left in place for a short period of time to allow the kidney to fully drain.
Most patients will spend the night in the hospital and have additional imaging to ensure that the fragments have cleared. In some cases if the fragments have not cleared, the procedure may have to be repeated, using the existing tract into the kidney. After all stones are gone, the stent is removed and the patient is discharged from the hospital. Recovery time is about one to two weeks.