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Percutaneous nephrolithotomy (PCNL) is a minimally-invasive surgery that helps in removing all types of stones from the kidney. This procedure requires a small puncture sized opening, around 1 cm, on the skin’s surface. 

PCNL is suitable for removing stones larger than two cm in size in the kidney and upper ureter (a tube that drains urine to the bladder). Patients are under general or spinal anaesthesia during this procedure.

How is PCNL performed? Before, during and after.

Doctors ask the patient to stop using certain medications they are currently taking that may alter the clotting effect of the blood. It is to prevent excessive bleeding during the surgery. Surgeons may also check for any signs of urinary tract infections (UTIs). 

Some common indications for this infection are burning while urinating, blood in the urine, increased urinary frequency and urgency, fever, etc. So, it is advisable to inform the doctor immediately so that they can prescribe the necessary tests and treatment before the procedure.

The patient lies face down on the abdomen, and the medical professional administers the anaesthesia to them. The surgeon will perform a cystoscopy, i.e., telescopic examination of the bladder. They send X-ray dye or carbon dioxide into the kidney. 

After mapping stones with a telescope, they break the stones into small pieces that they eliminate from the body using a laser or mechanical device. 

The patient may experience some effects such as pain, nausea, etc.

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Cost of the PCNL Procedure

Cost of the PCNL in India and Hyderabad

Ranges typically range from Rs. 49,000 to Rs. 2,00,000.

 

Number of days in the hospital

Around 2-3 days

Type Of surgery

Major

Anaesthesia Type

General 

Recovery

1-2 weeks

Duration of procedure

3 to 4 hours 

Surgery(Laser/Minimal invasive)

Minimally invasive

Risks and complications of the PCNL

Some risks and potential complications that are associated with PCNL are:

  • Bleeding: Blood loss during this procedure is generally minimal, and the risk of bleeding ranges from 2-12%, depending on the size and location of the stones. 
  • Infection: In some cases, bacteria can grow within the kidney stones and cause an infection. Hence, urinary infections should be treated before the PCNL procedure with antibiotics to lower the risk.
  • Failure to Remove the Stone: There is a slight risk of this happening with PCNL.
  • Organ Injury: Rare. However, some organs surrounding the kidney might get injured during surgery.

Who needs a PCNL?

Medical professionals advise PCNL in the following conditions:

  • Patients have large kidney stones blocking the collecting system branch of their kidney.
  • Patients have kidney stones larger than 2 cm.
  • The collecting tubes of the patient’s kidney show the presence of large stones.
  • Other treatments are unsuccessful.

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Frequently Asked Questions about PCNL

The results of this procedure are permanent. However, in some cases, new kidney stones can form. Hence, it is essential to treat the underlying reason to prevent the formation of new kidney stones. 

The removal of the newly formed stones will depend on the patient’s condition and medical advice.

Even though PCNL is a minimally invasive surgery, it is considered major surgery. The patient, in most cases, will be put under general anaesthesia, which requires following the same procedure that most major surgeries require.

The recovery time for PCNL surgery varies from person to person. In most cases, if the patient is healthy in other ways, it takes up to 1 to 2 weeks for a full recovery. The patient may be required to stay at the hospital for 1-3 days after the procedure.

The PCNL procedure requires puncturing the kidney to insert the device. It means that it damages the kidneys to a certain degree. However, studies have shown that PCNL is safe, and the kidneys will regain their function fully within six months.

Many studies have shown that PCNL is a safe and effective procedure for removing large kidney stones. However, there is a risk associated with PCNL like any other procedure. They are rare, but they can cause excessive bleeding, infection, etc.

PCNL can be performed as an outpatient procedure with good results. However, in most cases in India, especially if the patients need to take general anaesthesia, PCNL requires staying at the hospital for one to two days.

Because this procedure requires puncturing the kidney, creatinine levels will rise significantly in the next 48 hours in most cases. But once the patient starts to recover, they go back to normal eventually. 

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References

Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.

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