Kidney stones in adults: Surgical management of kidney and ureteral stones. Clinical trialsĮxplore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. You may also talk about ways to prevent getting more kidney stones in the future. Your surgeon or primary care provider may recommend blood tests to learn what caused the kidney stones. If you have a nephrostomy tube, your surgeon will remove it after giving you a local anesthetic. You may have ultrasound, X-ray or a CT scan to check for any stones that may be left and to make sure that urine is draining as usual from the kidney. If you have a nephrostomy tube for draining the kidney, you may return sooner. You'll likely see your surgeon 4 to 6 weeks after surgery for a follow-up visit. If you have significant pain that's not relieved by pain medication, contact your care provider. These could be signs and symptoms of infection, and you may need emergency care. If you develop a fever or chills, contact your primary care provider or surgical care team. If you notice blood or thick clumps of ketchup-like blood in your urine or drainage tube, go to the emergency department. If you have drainage tubes in the kidney left after surgery, you'll need to watch for any bleeding. You may be able to return to work after about a week. You may need to avoid heavy lifting and pushing or pulling for 2 to 4 weeks after surgery. You may stay in the hospital for 1 to 2 days after the procedure. Knowing what type of kidney stones you have may help your care provider suggest ways to prevent future stones. The kidney stones are sent to a lab to check what types of stones they are. For complicated cases, this tube also leaves access to the kidney if more kidney stones or fragments of kidney stones need to be removed during the recovery time. The nephrostomy tube allows urine to drain directly from the kidney into a bag worn outside the body during recovery. The surgeon may then place a different tube, called a nephrostomy tube, in this same passageway. Using specialized instruments that pass through the sheath, the surgeon breaks up the stones and removes them. Next, the surgeon place a tube (sheath) along the path of the needle. Or, a tiny camera may be threaded through the catheter, which allows your doctor to see the needle as it's placed in the kidney and other work during surgery. Through this catheter, your doctor can put a specialized tracer substance into the kidney that outlines structures inside the kidney so that they're more visible during imaging. The ureter is the tube connecting a kidney to the bladder. The urethra is the tube where urine exits the body. You may have a flexible tube (catheter) passed through the urethra, bladder and ureter into the kidneys. The needle placement may occur in the operating room or in the radiology department. The path of this needle becomes the passage for performing the rest of the procedure.Ī surgeon or a radiologist with specialized training in this procedure uses X-ray, CT or ultrasound images to guide the placement of the needle. To start the procedure, a specialized needle is inserted into a urine-collecting chamber of the kidney (calyx). Then you would receive general anesthesia after you're moved to surgery. In this case, you may be given a medication that numbs only a small area of your body (local anesthesia) in the radiology department. Sometimes, the first step of the procedure is performed in the radiology department. With general anesthesia, you won't be awake for the procedure and you won't feel any pain. Percutaneous nephrolithotomy is usually performed in the hospital under general anesthesia. Your surgeon may prescribe antibiotics to reduce your chance of developing an infection after the procedure. In some cases, you may need to stop these medications before your surgery. Let your care team know about all of the medications, vitamins and dietary supplements you're taking. You may be instructed to stop eating and drinking after midnight on the night before your procedure. Urine and blood tests check for signs of infection or other problems, and a computerized tomography (CT) scan shows where the stones are in your kidney. The most common risks from percutaneous nephrolithotomy include:īefore percutaneous nephrolithotomy, you will have several tests.
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