Percutaneous nephrolithotomy is usually performed in the hospital under general anesthesia. With general anesthesia, you won't be awake for the procedure and you won't feel any pain.

To start the procedure, a specialized needle is inserted into a urine-collecting chamber of the kidney (calyx). The path of this needle becomes the passage for performing the rest of the procedure.

A Urologist with specialized training in this procedure uses X-ray, CT or ultrasound images to guide the placement of the needle. The needle placement may occur in the operating room or in the radiology department.

You may have a flexible tube (catheter) passed through the urethra, bladder and ureter into the kidneys. The urethra is the tube where urine exits the body. The ureter is the tube connecting a kidney to the bladder. Through this catheter, your doctor can put a specialized tracer substance into the kidney that outlines structures inside the kidney so that they're more visible during imaging. Or, a tiny camera may be threaded through the catheter, which allows your doctor to see the needle as it's placed in the kidney and other work during surgery.

The surgeon place a tube (sheath) along the path of the needle. Using specialized instruments that pass through the sheath, the surgeon breaks up the stones and removes them.

The surgeon may then place a different tube, called a nephrostomy tube, in this same passageway. The nephrostomy tube allows urine to drain directly from the kidney into a bag worn outside the body during recovery. For complicated cases, this tube also leaves access to the kidney if more kidney stones or fragments of kidney stones need to be removed during the recovery time.

The kidney stones are sent to a lab to check what types of stones they are. Knowing what type of kidney stones you have may help your care provider suggest ways to prevent future stones.

You may stay in the hospital for 1 to 2 days after the procedure. You may need to avoid heavy lifting and pushing or pulling for 2 to 4 weeks after surgery. You may be able to return to work after about a week.

If you have drainage tubes in the kidney left after surgery, you'll need to watch for any bleeding. If you notice blood or thick clumps of ketchup-like blood in your urine or drainage tube, go to the emergency department.