Percutaneous Nephrolithotomy (PCNL)

minimum cost
₱ 0
maximum cost
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Things you need to know

1.What is PCNL​?
2.Why do you need it?
3.Why cost vary in philippines?
4.Surgery cost range by city
5.Surgery Procedure
6.Recovery
7.Risk and complications
8.FAQ
9.Conclusion

What is PCNL ?

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Why do you need PCNL?

PCNL is indicated for:

  • Kidney stones:
    • Large stones (>20 mm) or staghorn calculi (branched stones filling renal pelvis; 10–20% of complex stones).
    • Stones resistant to ESWL (e.g., cystine, hard calcium oxalate; ESWL success drops to 50–60% for >20 mm).
    • Stones causing obstruction, infection, or recurrent pain.
    • Incidence in India: 5–15% lifetime risk; higher in North India (hot climates, dietary factors).
  • Contraindications:
    • Uncontrolled bleeding disorders, active UTI (must be treated first), or pregnancy.
  • Associated treatments:
    • Pre-op: Ureteral stent or nephrostomy tube (if obstruction or infection).
    • Post-op: Double-J stent to aid drainage; stone analysis to guide prevention.
  • Timing:
    • Performed in adults (average age 30–50 years for kidney stones); urgency depends on symptoms (e.g., infection, severe pain).

The procedure aims to remove large stones directly, relieve obstruction, and prevent complications like infection or kidney damage, with a high success rate for complex stones.

Why Do PCNL Costs Vary in Philippines?

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PCNL Procedure

  • Before Procedure Evaluation:
    • Assessment:
    • Preparation: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; antibiotics pre-op; fasting 6 hours.
    • Consent: Risks, including bleeding, are explained.
  • Procedure Technique:
    • PCNL:
      • Performed under general anesthesia, lasting 1–3 hours.
      • Process:
        • Patient positioned prone (face down); fluoroscopy or ultrasound used to guide access.
        • Small incision (1 cm) in back; needle inserted into kidney (percutaneous access to renal pelvis).
        • Tract dilated to 1–1.5 cm; nephroscope (camera) inserted to visualize stones.
        • Stones fragmented (ultrasonic or laser lithotripsy) and removed with forceps or suction.
        • Double-J stent or nephrostomy tube placed to ensure drainage; tract closed or left with tube.
      • Completion: Stones sent for analysis; X-ray confirms clearance.
    • Intraoperative Tools:
      • Nephroscope: Visualizes stones.
      • Laser/ultrasonic lithotripter: Breaks stones.
      • Fluoroscopy: Guides needle placement.
  • After Procedure:
    • Hospital stay: 2–4 days.
    • Care: Nephrostomy tube (if placed) removed in 1–2 days; Double-J stent removed in 2–4 weeks.
    • Pain management: Moderate pain for 3–5 days; managed with painkillers (e.g., diclofenac).
    • Instructions: Drink 2–3 liters of water daily; avoid strenuous activity for 2–4 weeks.

Recovery After PCNL

  1. Hospital Stay: 2–4 days.
  2. Post-Procedure Care:
    • Pain: Moderate pain for 3–5 days (back/flank); resolves in 1–2 weeks.
    • Urine: Blood-tinged urine (hematuria) for 3–5 days; clears with hydration.
    • Activity: Avoid strenuous activity for 2–4 weeks; light activities in 3–5 days.
    • Tubes: Nephrostomy tube removed in 1–2 days; Double-J stent removed in 2–4 weeks (may cause mild discomfort).
    • Diet: Hydrate (2–3 liters/day); low-sodium, low-oxalate diet to prevent recurrence.
  3. Follow-Up:
    • Visit at 1 week (check healing), 2–4 weeks (stent removal), and 3 months (confirm clearance).
    • Imaging: X-ray or ultrasound at 1 month to ensure stone-free status (90–95% clearance rate).

Most resume normal activities in 1–2 weeks; full recovery takes 4–6 weeks. Success rate: 90–95% stone clearance for large stones; 5–10% may need additional procedures (e.g., ESWL for residual fragments).

Risks and Complications

  • Procedure Risks:
    • Bleeding (5–10%): During tract creation; may need transfusion (1–3%) or embolization (rare, <1%).
    • Infection (3–5%): Sepsis risk if pre-op UTI untreated; managed with antibiotics.
    • Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
  • Post-Procedure:
    • Urine leak (1–3%): From kidney puncture; usually resolves with stent or nephrostomy tube.
    • Injury to nearby organs (1–2%): Colon, spleen (rare); may need surgical repair.
    • Residual fragments (5–10%): Small fragments may remain; may need ESWL or ureteroscopy.
    • Hydronephrosis (1–2%): Obstruction from clot or fragment; managed with stent.
  • Long-Term:
    • Recurrence (30–50%): Stones recur within 5–10 years; needs dietary changes and monitoring.
    • Kidney function decline (<1%): Minimal impact if no complications; monitor creatinine.

Report fever, severe pain, heavy bleeding, or decreased urine output promptly.

Frequently Asked Questions (FAQs)

What causes the need for PCNL?

Large kidney stones (>20 mm), staghorn calculi, or stones resistant to ESWL causing pain, obstruction, or infection.

Can I avoid PCNL?

Yes, if smaller stones: ESWL or ureteroscopy; PCNL needed for large or complex stones.

Is PCNL painful?

Moderate pain for 3–5 days, managed with medication; resolves in 1–2 weeks.

How soon can I resume normal activities?

Light activities: 3–5 days; full recovery: 4–6 weeks; avoid strenuous activity for 2–4 weeks.

Is PCNL covered by insurance in India?

Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.

Signs of complications?

Fever, severe pain, heavy bleeding, or decreased urine output.

Will all stones be removed in one session?

Usually: 90–95% clearance in one session; 5–10% may need additional procedures for residual fragments.

Lifestyle changes post-procedure?

Hydrate (2–3 liters/day), reduce salt/oxalate intake, monitor for recurrence, and attend follow-ups.

Conclusion

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Looking for Best Hospitals for

Note: we are not promoting any hospitals

We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

  • click on your city and schedule your surgery now done in good hands.
City Minimum Price (₱) Maximum Price (₱)
Angeles City
Antipolo
Bacolod
Bacoor
Baguio
Butuan
Cagayan de Oro
Caloocan
Cebu City
Dasmariñas
Davao City
General Santos
General Trias
Iligan
Iloilo City
Las Piñas
Makati
Malolos
Manila
Muntinlupa
Parañaque
Pasay
Pasig
Puerto Princesa
Quezon City
San Fernando
San Jose del Monte
Taguig
Valenzuela
Zamboanga City

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.

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