PCNL

Percutaneous Nephrolithotomy (PCNL)

For larger, more complex stones, or for specific circumstances, PCNL may be the optimal approach to treating your kidney stones. This procedure is more invasive that shockwave lithotripsy or ureteroscopy, and therefore is reserved for situations when it is most appropriate.

The urologists at Fore River Urology and the Maine Kidney Stone Center have the expertise to offer personalization and customization of your PCNL to best address your health status and your kidney stone burden.

Mini-PCNL

In some circumstances, a mini-PCNL can be performed. This is often an outpatient procedure involving a smaller sheath compared to the video described above. This allows for a lower risk of complications.

Tubeless PCNL

The urologists at Fore River Urology and the Maine Kidney Stone Center have the expertise to offer tubeless PCNL. This means that at the end of the procedure the patient does not require a nephrostomy tube (tube draining from the kidney into an external bag).

However, it is often not truly tubeless, as a ureteral stent does need to be placed at the end of the procedure and kept for 7-14 days.

Supine PCNL

Traditionally, PCNL was/is performed with the patient in the prone position (lying on their stomach) while under anesthesia. Recent innovations have now allowed select patients to have this procedure done supine (lying on your back).

This is not appropriate for everyone, but can be helpful during the procedure for good drainage of urine/stones as well as optimizing anesthesia care.

Advantages

• Effective at treating large complex stones
• Minimally invasive

Risks/Complications

• 1-2% risk of bleeding which could result in needing a blood transfusion or a procedure to embolize a tiny bleeding vessel
• Infection
• Urine leak (if the kidney does not heal properly)
• Inability to remove the stone
• Need for additional procedures
• Pain
• 1 night hospital stay