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Radical Nephrectomy

The most common reason to perform a nephrectomy is for control and treatment of cancer. Other possible indications for a nephrectomy include benign diseases that lead to kidney dysfunction. These diseases include advanced kidney stones, chronic infections, and some benign tumors.

There are several different variations on how a nephrectomy is performed determined primarily by the type of disease that is being treated.

  • Radical nephrectomy: This is a procedure in which the entire kidney along with the surrounding connective tissue and ureter are removed. This is most commonly performed for cancer.
  • Simple nephrectomy: In this procedure, the kidney and a portion of the ureter are removed while leaving the surrounding connective tissues. This is generally performed for non-cancerous indications.
  • Partial nephrectomy: In this procedure, only the tumor or diseased portion of the kidney is removed while leaving behind otherwise normal tissue. By leaving the remaining kidney, overall kidney function is improved post-operatively. This has become a common surgery for kidney cancer, but its use is restricted to only certain types and sizes of kidney tumors.
  • Laparoscopic nephrectomy: Any type of nephrectomy can be performed through either a traditional open approach or a laparoscopic approach. The open approach implies performing the nephrectomy through an incision that generally ranges between 8 to 16 inches long. The laparoscopic approach utilizes surgical scopes to remove the kidney tissue. Variations of the laparoscopic approach include hand assisted laproscopic surgery, as well as robot assisted laproscopic surgery using the DiVinci Robotic System. The choice of surgery depends largely upon the size and location of the kidney tumor, as well as some specific patient issues. Kansas City Urology Care surgeons offer all varieties of nephrectomy.

What are the symptoms after a nephrectomy?

By the time you are discharged from the hospital, you should be independent in activity and with good pain control with the help of pain medication. Regardless of the type of nephrectomy that is performed, it does take the body several weeks to heal following a major surgery such as a nephrectomy. It is therefore common to have discomfort in the region of your incision for several weeks. Incisions gain strength over time and reach significant strength at six weeks following surgery. It is very common to have numbness in the skin surrounding and adjacent to any large incision, especially incisions on the flank. Occasionally, muscles within the region are weak and may show signs of relaxation, thus producing a small bulge near the incision.

Easy fatigue is also a common finding and can range from several weeks to several months following any major surgery depending on the patient’s age and overall health and endurance level.

It is not uncommon to occasionally have blood in the urine following partial nephrectomy for several weeks. Additionally, regardless of the type of nephrectomy performed, constipation can be a common problem especially considering the use of narcotic pain medication following surgery. It will be important for you to continue to monitor this closely and use over-the-counter laxatives or stool softeners as indicated.



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