PCNL Full Form in Medical Science: When Is the Surgery Needed?

Kidney stones can be extremely painful, especially when they are too big to be removed naturally with medications. In such situations, the doctor recommends PCNL.

Most of the time, people get confused or anxious about this procedure due to limited awareness. This is why we created this guide to provide you with a clear understanding of the PCNL full form, meaning and other crucial details.

What is the PCNL Full Form and Meaning?

PCNL full form in medical science is Percutaneous Nephrolithotomy.

Percutaneous means a procedure accessing the kidney through a small incision in the skin. Nephrolithotomy means the surgical removal of a calculus or stone from a kidney.

This is generally a surgical procedure used to remove kidney stones that are so large that they can not pass on their own. These stones are composed in the urinary tract due to crystallisation of chemical compounds in the urine.

In this condition, they do not respond to other treatments. This procedure typically takes 2 to 4 hours to complete.

When is PCNL Surgery Recommended?

PCNL medical surgery is usually recommended under the following circumstances:

1. Large kidney stones, also known as Staghorn kidney stones, block more than one branch of the kidney.
2. Kidney stones expand more than 0.8 inches (2 centimetres) in the human body.
3. Stones are positioned in a way that makes it difficult or impossible to pass naturally through the urinary tract.
4. The tube connecting a kidney and the bladder (ureter) gets blocked with large stones.
5. Symptoms associated with kidney stones, such as intense pain or obstruction of urine flow, become severe.

Precautions Taken Before a PCNL Surgery

As you now know the PCNL full form, meaning and when an individual is required to opt for this surgery, it is important to understand what precautions are generally taken before performing this procedure.

Medical Evaluation

Before beginning the PCNL operation, a healthcare provider thoroughly evaluates the overall condition of the patient. The aim of it is to assess their pre-existing conditions, such as any chronic kidney disease, bleeding or coagulation disorders, that can result in severe complications and even the death of the patient.

Imaging Tests

To obtain a clear view of the kidney stones, doctors typically initiate imaging tests prior to surgery. These tests include a CT (computed tomography) Scan, Ultrasound and X-Ray to provide a precise idea about the stone's size, shape and location.

Review of Current Medications

In most cases, patients are advised to stop taking certain medications before PCNL surgery. Drugs such as aspirin, anti-inflammatory medicines and some herbal supplements can increase the risk of bleeding during the procedure.

Diet Restrictions

Doctors usually impose specific restrictions on food and drink the day before proceeding with the PCNL surgery. For anyone about to have this surgery, eating or drinking anything after midnight on the night before surgery is strictly prohibited. Even while taking medications, they have to swallow with a small sip of water.

What Happens During PCNL Surgery?

Like every other surgery, a PCNL operation is also performed in a hospital operating room under general anaesthesia. The section below outlines the steps involved in this surgery.

1. The patient is taken to the OT and made unconscious using anaesthesia to ensure they remain pain-free during the procedure.
2. Doctors insert a 1 cm incision in the patient’s flank area.
3. Through this opening, a tube is carefully guided into the kidney using X-ray imaging.
4. Through the tube, a small telescope is passed to show a clear image of the stone.
5. The stones are broken into smaller pieces and then removed from the body.
6. After removing the stones, the incision may be closed with sutures or covered with a sterile dressing.
7. The patient will usually be kept under observation for 1 to 2 days at the hospital.

Get comprehensive health insurance from Bajaj General Health Insurance to cover the expenses of PCNL surgery. With our assistance, you can receive proper financial support before and after hospitalisation at our wide range of network hospitals.

Potential Risks and Side Effects After PCNL Surgery

PCNL surgery generally has a high success rate in removing kidney stones. However, like any surgical procedure, it carries certain risks and possible complications, which may include:

1. Anaesthesia Risks: General anaesthesia can sometimes cause complications, such as severe allergic reactions, malignant hyperthermia and nausea.
2. Bleeding: In rare cases, severe bleeding can occur before or after the surgery, requiring a blood transfusion.
3. Infection: Although generally used to reduce complications, broad-spectrum antibiotics can still cause infections in specific cases.
4. Tissue or Organ Damage: There is a slight possibility that, in certain cases, organs surrounding the kidney, including bowel, spleen, liver or blood vessels, may be damaged during instrument insertion.
5. Urinoma: The PCNL surgery can lead to this condition, causing urine to collect outside of a kidney.
6. Unsuccessful in Removing Stone: Medically termed as Residual Stone Fragments, in rare instances, a few stone fragments might stay after the procedure.
7. Pulmonary Issues: In severe cases, pulmonary issues, such as pleural effusion, fluid around the lung, collapsed lung(pneumothorax) and other respiratory problems, might occur.
8. Fever: Especially for patients with diabetes, fever is the most common risk factor.

Post-Hospitalisation Care Measures for PCNL Surgery

A patient usually takes 2 to 4 weeks to fully recover from PCNL surgery. Although the timeline can change depending on individual health conditions, the following measures are taken to ensure a patient's fast recovery.

Restrictions on Activities

PCNL surgery recovery time can increase if the patient does not avoid strenuous activities, such as heavy lifting (approximately 8.5 pounds), pushing or pulling. These activities have to be restricted for around 4 weeks to help the kidneys and incision site heal completely. In fact, any negligence can cause severe bleeding.

Pain Management

It is common for patients to experience discomfort and pain after the procedure. This is why doctors prescribe medications to manage pain. If the patient ignores recovery guidelines, the pain at the surgical site can worsen and may not respond well to medication.

Complete Hydration & Nutritious Diet

To recover fully from the effects of PCNL operation, a patient needs to maintain a good diet and stay hydrated at all times. With proper fluid intake, they can flush out any remaining stone fragments and quickly heal the urinary tract.

Observe the Symptoms

If you or any of your acquaintances are recovering from the PCNL surgery, always monitor every symptom to avoid any further complications. For instance, if you see heavy bleeding at the incision site, dark blood in urine, high fever or blood clots, immediately visit your doctor.

Follow-up Appointments

Health care providers schedule a follow-up appointment to have a full screening of the patients. In this appointment, they basically scan imaging tests, ask about any complications and have a further discussion about treatment or preventive measures.

What are the Advantages of Percutaneous Nephrolithotomy?

Now that you understand the PCNL meaning and post-operative care measures, let's explore why doctors highly recommend this surgery:

1. High Success Rate: For its high success rate of approximately 75% to 98%, this procedure is highly recommended by professional health care providers.
2. Advanced Treatment: It is usually considered less risky as doctors use the laser lithotripsy technique here, which removes kidney stones without any need for surgery.
3. Quick Recovery: Patients can often go home in 1 to 2 days after the surgery, thus it automatically cuts hospital costs and allows quicker reintegration into life.
4. Minimally Invasive: Unlike any open surgery, for PCNL surgery, doctors use a tiny incision (around 1 cm) to reduce concussion, infection risk and scarring.

Final Word

For people struggling with kidney-related complications, understanding the PCNL full form and meaning can turn out to be beneficial if they require it in future. Luckily, this surgery generally has a high success rate and can cause fewer complications.

However, patients are recommended to take proper care and monitor their symptoms to prevent any minor issues from getting severe.

If you want to get financial assistance to cover the PCNL operation cost, the comprehensive health insurance plan from Bajaj General Insurance will be there for you!

Frequently Asked Questions

Can I get a cashless treatment facility for PCNL surgery?

Yes, every reliable health insurance provider will offer the benefit of a cashless treatment facility for PCNL surgery or any related medical procedure at their network hospitals. However, this facility is limited to the specific lists of network hospitals, which can vary across different providers. This is why you should purchase a policy from a provider that includes network hospitals near your location.

How painful is PCNL surgery?

PCNL surgery is usually moderately painful for most people. The ureteral stent tends to be the most painful part of the procedure. However, your healthcare provider will prescribe pain relievers to reduce the pain.

Will the ambulance cost for PCNL surgery be covered by a health insurance plan?

Yes, ambulance costs are covered by most health insurance plans for medically necessary procedures like PCNL surgery, along with pre- and post-hospitalisation. However, it is essential to verify before purchasing a policy whether your provider is offering this policy.

What lifestyle changes can I make to prevent future kidney stones?

The best possible way to prevent kidney stones is by drinking plenty of water. A grown individual should aim to drink up to 3 litres (5.2 pints) of fluid throughout the day. Moreover, citrus fruits such as lemons, limes and oranges are also a great remedy to prevent kidney issues.

Is it normal to have blood in urine after PCNL surgery?

Yes, it is normal to see some blood in your urine for one to two weeks after PCNL surgery. Most of the time, the blood appears pink, reddish or brownish. However, if a patient is having excessive bleeding, it requires immediate medical attention.

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