[shart]

Hello, I am new to the forum. I need to have percutaneous nephrostolithostomy on my left kidney to remove 5 large stones. The urologist feels my right kidney has been blocked for some time by a stone, and has been permanently damaged, however further tests need to be done. I wanted to find out what the procedure I have to have on the left kidney is really like, in terms of pain, recovery, etc.. If you have had this procedure, or have any advice you could give me, please do so. I am very nervous and scared, but am trying to be optimistic. Thank you.

[haylee_beutler]

I am so glad that i came accross your question. I just had a percutaneous nephrostomy/ percutaneous nephrostolithostomy done on November 6th, 2008. You can also find my story in these post as well, entitled "My story, 22mm stone, PCNL surgery". This will give you a first hand look at my experience.

The surgery itself is a complicated procedure so make sure you have a good certified urology surgeon. It is done pretty frequently with great success, but it is a difficult procedure and many surgeons are not certified for this. Normal hospital stay time is 2-4 days, and normal recovery time is about 1-2 weeks.

Here is the basic outline of the procedure itself. You will be taken either to the operating room or a radiology room where they will insert a "nephrostomy" tube directly into your back and into your kidney. This tube is about 1/2" - 3/4" inch round. Depending on the surgeon, some patients do not get a nephrostomy tube placed. This tube is used to help drain your kidney during the surgury and during recovery. Some patient's have this placed during their actual surgery under general anesthesia and some will have these placed prior to the surgery, awake and using a "conscious sedator" medication, which means you are awake but you wont remember anything when it is over.

After the nephrostomy tube is placed into your kidney, you will be taken to the operating room (unless you are already there) and you will be put under and placed in a prone position (on your belly) and the procedure will begin. First, they will usually place a Foley catheter into your bladder. Then they will begin to insert guide wires into your kidney and a "baloon" device used to create a "tunnel" into your kidney. The surgeon will then locate the stone and begin to break it down. The stone fragments will be sucked out as they are broken down. The procedure itself can take 1-4 hours. (Mine was 3 hours)

The success rate for this surgery is very high. Although, it is common for a few stone fragments getting left behind, but not to worry, most of the fragments are very small and easy to pass on your own. Complications of this procedure are very minimal and include bleeding (very mild), infection, fever, and in very rare cases damage to internal surrounding organs.

I was in the hospital for 3 days when i had mine, but i actually felt like i should have stayed 1 more. A word of advice is to not let the Doc or nurses force you into going home if you are not feeling quite yourself yet. I didn't have much pain after the procedure considering all i could do is lay in the bed for 2 days. The catheter was removed on the 3rd day, allowing me to walk around. However, for the first few days, you will have a hard time geting out of bed or rolling over. Everytime i had to move my back it hurt. After about a week, i was able to get out of bed without assistance. My nephrostomy tube was removed from my pack on the 4th postoperative day. When you get that tube removed, you will notice "leakage" out of that incision. That was one thing i had not read about. My incision was a little larger than normal so i "leaked" out my back incision for about 4 days. It was like clockwork, every time i drank, it just came out my back less than 30 minutes later.

After a normal successful procedure, you should be able to go back to work in 1-2 weeks.

However, i had complications with my procedure. The stone was hard to locate, very large, and the doctor ended up doing more "digging around" than he was expecting, causing me to lose a little more blood than was normal and i required transfusions. Only about 2% of these surgeries experience enough blood loss to require transfusions.

My stone was 22-25 mm in size and it was a struvite (infection) stone which is a hard consistancy. Calcium oxolate stones and uric acid stones are usually easily broken up during surgery. How many stones do you have and what sizes? Also, what is your age?. Many older females with stones are recommended to get a bone density scan because calcium oxalate stones are a sign that your bones may not be getting all the calcium needed and can lead to osteoporosis.

I would love to hear back from you on your progress and recovery. Please email me personally if you have any other questions. I would be happy to answer "anything" you might be concerned about. I felt like i was "blind" because i couldn't find any good information on the web about the surgery and what it would be like and recovery. So, i would be glad to answer all of your questions. My email is [moderator note: e-mail address has been removed]

Look forward to hearing from you! Good luck!
Haylee Beutler