Version July 2025
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What are discharge instructions? —
Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.
What is percutaneous nephrolithotomy? —
Percutaneous nephrolithotomy, or "PNL," is a procedure to remove 1 or more kidney stones. These are just what they sound like: small stones that form inside the kidneys (figure 1). They form when salts and minerals that are normally in urine build up and harden.
During PNL, a doctor makes a very small cut, or "incision," in the skin. They pass tiny tools through the incision and into the kidney. Then, they remove the stone.
How long it will take for you to recover, and what you need to do, depends on your situation.
How do I care for myself at home? —
Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.
You should also:
●Take all your medicines as instructed:
•Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Follow all instructions for taking your pain medicines.
•Take non-prescription medicines to relieve pain, such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve). You can take these instead of opioids.
●Take care of your urinary tract:
•Drink plenty of water – This will help flush out your urinary tract.
•Know what to expect when you urinate – You might see blood in your urine for a few days after PNL. This is normal. If you had a stent placed, you might also feel pain in your back, side, or bladder, or a burning feeling when urinating. A stent might also make you need to urinate more often or in a hurry.
•The doctor might ask you to strain your urine using a filter. This will collect the pieces of the stone when they come out. The doctor might want to run tests on the stone to learn more about it.
•Empty your bladder as soon as you feel the need. Don't delay going to the bathroom. This can stretch and weaken the bladder.
•If you have a bladder catheter, nephrostomy tube, or ureteral stent, make sure you know how to care for them at home.
●Take care of your incision – You might have stitches, surgical glue, or a special skin tape on your incision.
•Keep your incision dry and covered with a bandage for the first 1 to 2 days. Your doctor or nurse will tell you exactly how long to keep it dry.
•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put it underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.
•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on it. They will also tell you if you need to cover it with a bandage or gauze.
•Always wash your hands before and after you touch your incision or bandage.
●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.
•Keep coughing and doing deep breathing exercises for 7 to 10 days after you go home. This helps prevent lung infections. When you cough, sneeze, or do deep breathing exercises, press a pillow across your incision to support the wound and ease pain.
•Avoid heavy lifting, sports, and swimming for at least a week or 2. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)
●Eat when you are hungry – If you have an upset stomach, it might help to start with clear liquids and foods that are easy to digest, like soup, pudding, toast, or eggs. You can eat other types of foods when you feel ready. If your doctor or nurse gave you specific instructions about what to eat or avoid, follow them.
What follow-up care do I need? —
The doctor will want to see you again after surgery to check on your progress. In a couple of months, they will also want to do imaging tests to make sure your kidney stones are gone. Go to these appointments.
If you have stitches, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or skin tape, it will fall off on its own. Do not pick at it or try to remove it yourself.
If you got a bladder catheter, nephrostomy tube, or ureteral stent, the doctor will tell you how long these need to stay in place. You might need another appointment to remove or replace them.
When should I call the doctor? —
Call for emergency help right away (in the US and Canada, call 9-1-1) if: you have
●Severe belly or back pain
●Chest pain or trouble breathing
Call for advice if:
●You have signs of an infection – These include a fever of 100.4°F (38°C) or higher, chills, or pain when urinating.
●You still had bad pain even after taking pain medicines.
●You have a lot of bleeding from your urethra (figure 1), or the bleeding lasts longer than 5 days.
●You have blood clots in your urine that are the size of a dime or bigger (3/4 inch, or 1.7 cm).
●You are not urinating, or urinating only a little.
●Your urine is cloudy, smells bad, or has more blood in it than before.
●Urine leaks from your body.
●You have redness or swelling around your incisions.
●You have nausea or vomiting for more than 2 days after going home.
●Your bladder catheter, nephrostomy tube, or ureteral stent comes out, if you got one.
Patient education: Percutaneous nephrolithotomy (The Basics)
Patient education: Kidney stones in adults (The Basics)
Patient education: Kidney stones in children (The Basics)
Patient education: Urinary tract infections in adults (The Basics)
Patient education: Urinary tract infections in children (The Basics)
Patient education: How to care for a nephrostomy tube (The Basics)
Patient education: Ureteral stent placement (The Basics)
Patient education: Kidney stones in adults (Beyond the Basics)
Patient education: Kidney stones in children (Beyond the Basics)
Patient education: Urinary tract infections in adults (Beyond the Basics)
Patient education: Urinary tract infections in children (Beyond the Basics)
