Percutaneous nephrolithotomy in Turkey/Istanbul is considered the ideal method for fragmenting and extracting large kidney stones, especially those located in the pelvis or ureter.
Description of percutaneous nephrolithotomy
Percutaneous nephrolithotomy (PNL) is a simple procedure used for large stones inside the kidney, but it is not used for stones inside the ureter or bladder.
It is used if there is a large stone (usually more than 1-2 cm in size), and it cannot be broken up with a shock wave device from outside the body or through ureteroscopy.
Although this procedure is more invasive than shock waves, it is more effective for large stones, especially if they are hard.
It is the treatment of choice for deer antler stone, a large stone that almost fills the kidney. Percutaneous nephrolithotomy (PNL) requires general anesthesia.
This procedure requires an integrated medical team, including a urologist, a radiologist, and a full surgical team (such as a physician, anesthesia technician, nursing assistant, surgical assistant, and radiology technician).
The patient will also be required to stay in the hospital for some time after treatment.
Before performing percutaneous nephrolithotomy
- CT scan to determine the location and location of the stone
- Anesthesia consultation required
- Blood tests and ECG
- Fasting the night before
- Medications: You will receive instructions about any changes. In general, you will be asked to stop all medications predisposing you to bleeding (such as Plavix, Coumadin/warfarin, and aspirin).
Percutaneous nephrolithotomy surgery in Turkey
Percutaneous nephrolithotomy is performed under general anesthesia.
The patient lies on his stomach, face down. Once anesthesia is given, your doctor will perform a cystoscopy (a telescopic examination of your bladder) and inject X-ray dye into the kidney through a small catheter placed through the ureter to clearly “map” the kidney.
This allows the surgeon to precisely locate the stone within the kidney and place a small needle through the skin under X-ray guidance to directly reach the area where the stone is located.
The stones are broken down into small pieces and extracted from the body using an ultrasonic, mechanical, or laser fragmentation device.
Sometimes, more than one device may be needed to access all stones and attempt to remove them.
A small ureteral catheter may be left in place to drain stones from the kidney into the bladder and a tube that acts as a drain through the kidney to an external drainage bag at the end of the procedure.
The duration of surgery generally takes 3-4 hours.
Verifying the success of percutaneous nephrolithotomy
The next day after the surgical procedure, the doctor performs tests to ensure the success of the operation before leaving the hospital.
Fortunately, the majority of patients will be able to leave the hospital without stones.
Sometimes, stones cannot be extracted, and additional procedures such as shock wave lithotripsy (ESWL), ureteroscopy, or even repeated percutaneous nephrolithotomy are required.
In some cases, a catheter may be left within the ureter to allow fragments to pass and/or allow the kidney to heal properly.
You will be informed if additional procedures are needed later, such as removing the catheter, ureteroscopy, or morcellation sessions.
Potential risks
One of the great benefits of percutaneous nephrolithotomy is that it helps the patient get rid of the stones with a less invasive procedure than the procedures used in the past.
Fortunately, the patient is rarely treated with open surgery now because it requires a large incision in the body, and the need to stay a few days in the hospital and several weeks of rest are recommended for recovery.
While percutaneous nephrolithotomy is much better than open surgery, it does carry some risks.
The incidence of potential risks is about 5-10%, While the incidence of more serious complications is small, about 1-2% of cases.
These include the following:
Bleeding: about 5% requiring a blood transfusion: occurs commonly during the procedure but may occur late during the first month after surgery
. If severe and severe bleeding occurs or the amount of pre-existing bleeding increases, tell your doctor and go to a nearby hospital. Sometimes, part of the kidney must be embolized to stop the bleeding.
Damage to nearby organs (such as the spleen, colon, liver, and lung) can occur, which is rare and uncommon.
If you have questions that have not been answered here, please contact us.
What to expect from percutaneous nephrolithotomy in Turkey ?
It is normal for some blood in the urine and bruising to appear on the lower flank after the procedure. The problem usually resolves within days to a few weeks on its own.
As long as the blood in the urine is light, there is generally nothing to worry about.
Urinary tract infections can sometimes occur, depending on the type of stone removed. Antibiotics are given after stone extraction to prevent infection, but if you have a fever, please ask your urologist.
Sometimes a small tube is temporarily inserted into the skin to drain pus and fluid from the kidney. This will be removed as soon as it is safe to do so.
When should you see a doctor after percutaneous nephrolithotomy?
Please inform your doctor if you have any of the following:
- Severe bleeding in the urine
- Feeling faint or dizzy despite consuming sufficient amounts of food and fluids
- High body temperature
- Very painful symptoms appear
Bimaristan Medical Center remains your first choice for treatment in Turkey.
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Do not hesitate to contact us at Bimaristan Family Center in Turkey. Our website also provides information about bladder cancer and its treatments in Turkey.
To learn more about the kidney transplantation process in Turkey and to learn more about percutaneous removal of kidney stones, you can contact us
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