Percutaneous Nephrolithotomy as Therapy for Kidney Stone

Dimas Nugroho, Ponco Birowo, Nur Rasyid

Research output: Contribution to journalArticlepeer-review

Abstract

A minimal invasive procedure, Percutaneous Nephrolithotomy (PCNL) is purposed to extract kidney stones by percutaneous access. It is indicated in: (1) simple pyelum stone, sized more than 2 cm, (2) kalyx stone, especially more than 2 cm sized, (3) multiple stone, (4) ureteropelvic junction and proximal ureter stone, (5) large kidney stone, (6) stone in solitary kidney. Coagulopathy and active untreated urniary tract infection are contraindicated undergoing PCNL. The advantages of this procedure are relaltively high stone free rate (90%), able to treat large kidney stone and inferior kalyx stone, low morbidity. The need of skillful and experienced operator is the disadvantage of PCNL. Stones size less than 1 cm could be extracted directly during PCNL by using forcep, while those whose sized are more than 1 cm need fragmentation by litotriptor. In cases with small stone burden and uncomplicated, tubeless PCNL is indicated to replace nefrostomy post operatively. It was reported that bleeding, renal pevis trauma, fluid absorbtion, pleura cavity trauma, intestine perforation, hepar/spleen trauma, and sepsis exist as complication of PCNL with incidence rate varies between 0% to 8%.Keywords: kidney stone, PCNL, therapy
Original languageEnglish
JournalJournal of the Indonesian Medical Association
Volume61
Issue number3
Publication statusPublished - 2011

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