Simple Nephrectomy (Kidney Removal)

What is a simple nephrectomy?

A simple nephrectomy is removal of an entire kidney.

When is it used?

The reasons for performing a simple nephrectomy include:

• There may be cancer in your kidney.
• You may have large stones in your kidney.
• Your kidney may be damaged and very small, causing high blood pressure.
• You may have an infection that antibiotic treatment cannot cure.

An alternative to this procedure is to choose not to have treatment, recognizing the risks of your condition. You should ask your healthcare provider about this choice.

How do I prepare for a simple nephrectomy?

Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after the surgery.

If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. Also avoid medicines that may contain aspirin, such as nonprescription cold medicines. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.

Follow any other instructions your healthcare provider may give you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You will be given a general anesthetic. It will relax your muscles and cause a deep sleep. It will prevent you from feeling pain during the operation.

The surgeon makes a cut in your side and lower back, or in the front of your abdomen. The surgeon pushes the organs and tissues around the kidney out of the way and exposes the kidney.

In a simple nephrectomy the surgeon separates the kidney from the vein, artery, ureter (the tube that runs from the kidney to the bladder), and the fat tissue around it, and removes the kidney. The surgeon then ties off the vein, artery, and ureter. If cancer is strongly suspected, then a radical nephrectomy is performed. This means the kidney is removed along with surrounding tissue (fat and lymph nodes) and the ureter down to the bladder.

What happens after the procedure?

You may be in the hospital for about 4 to 7 days. A catheter (tube) remains in your bladder for a few days to allow urine to drain and relieve the pressure. The catheter will be removed before you go home.

During the first 2 weeks after the operation, you will be encouraged to do light activity, such as walking. Avoid all heavy activity for the first 6 weeks, including lifting. After that time, you may gradually do heavier work according to your provider's instructions.

Ask your healthcare provider how to care for yourself during your recovery. Ask when you should come back for a checkup.

What are the benefits of this procedure?

The kidney and its contents, such as stones, cancer, or infection, will be removed.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• You may have infection or bleeding.
• Your spleen, adrenal gland, or pancreas may be injured during this operation.
• The nerves in the area may be damaged either by pressure or by being cut. This could cause problems with the muscles in your lower back. This could also cause the side to sag. You could also lose some or all of the feeling in your lower back. This could either be a temporary or permanent condition.
• If you had cancer, not all of it may have been removed, and the cancer may grow back.
• Your kidney function will be tested before surgery. If your remaining kidney is weak, your healthcare provider will discuss this special risk with you before surgery. You may need dialysis later in life. Dialysis is a mechanical way to do the work your kidneys normally do.

Ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You are in a lot of pain.
• You become unusually weak.
• The wound is leaking or bleeding.
• You are unable to pass urine.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.