What Is a Nephrolithotomy?
A nephrolithotomy is a surgical procedure that removes kidney stones. Kidney stones are formed when urine is super-saturated with certain minerals. They can occur in patients who have low urinary output, excrete a lot of salt or have acidic urine. Kidney stones range in size from microscopic crystals to the size of a golf ball, and they may sometimes pass out of the body in a urine stream. If they are large, their passage from the kidney, through the urethra, and out of the body can be very painful.
A surgeon performs a nephrolithotomy to relieve a patient’s pain or to remove blockages caused by kidney stones. The surgery is usually performed on patients who have kidney stones that are larger than 1 inch (2 cm) in diameter, that block the flow of urine from the kidney, and that cannot be treated by other means. The first nephrolithotomy was performed in 1973, and the surgery has a 95% success rate.
Patients undergoing a nephrolithotomy receive general, regional, or spinal anesthesia before the procedure begins. First, the kidney stone’s location must be determined, and then a small incision is made in the patient’s lower back. A needle is passed through the incision into the kidney and a guide wire is passed through the needle. A tube is then passed over the guide wire, and the stone is removed through the tube. If the surgeon crushes the stone before removal, the procedure is known as a nephrolithotripsy.
A patient who undergoes a nephrolithotomy can often expect to remain in the hospital for two or three days after the procedure. He or she will most likely have a catheter to drain urine until the kidney heals. Patients will be encouraged to drink large quantities of water during the healing process; it is normal to have some blood present in the urine. Most people can return to work after a few weeks.
The risks of a nephrolithotomy include bleeding, kidney perforation, and injury to other abdominal organs. Bleeding may occur if there is injury to blood vessels during the surgery. The kidney may be nicked by a scalpel, but this complication is not serious and usually corrects itself. A rare, but more serious, complication is injury to organs near the kidneys. In some cases, there has been damage to the spleen, liver, or gallbladder.
Written by E. Fogarty
