In urology, a PCN, or Percutaneous Nephrostomy, is the first step in accessing the renal collecting system to allow for the percutaneous insertion of instruments used to treat kidney stones, particularly through a procedure called Percutaneous Nephrolithotomy (PCNL).
Understanding Percutaneous Nephrostomy (PCN)
Essentially, a PCN involves creating a small, minimally invasive tract directly from the skin on your back into the kidney. This tract then allows surgeons to insert specialized instruments to break up and remove large kidney stones that are not amenable to other treatments like shockwave lithotripsy (SWL) or ureteroscopy.
Why is a PCN Performed?
PCNs are primarily performed to provide access for PCNL, which is used for:
- Staghorn calculi: These are large, branched stones that fill a significant portion of the renal collecting system.
- Large Renal Pelvis Stones: Stones typically larger than 2 cm located in the renal pelvis.
- Lower Pole Stones: Stones in the lower part of the kidney that are usually larger than 1 cm.
PCN: The First Step to PCNL
The PCN procedure is the crucial initial step in PCNL. Without establishing percutaneous access to the kidney via PCN, the larger, more complex stone removal can't be accomplished in a minimally invasive fashion.
In Summary
PCN is a vital urological technique that provides a pathway into the kidney, primarily to facilitate the removal of large kidney stones through percutaneous nephrolithotomy. It is a minimally invasive procedure that offers an effective alternative when other stone treatments are not suitable.
