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:

• You may have large stones in your kidney.

• Your kidney may be very small and causing high blood pressure.

• You may have an infection that antibiotic treatment cannot cure.

• Your kidney may have cancer.

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

How do I prepare for a simple nephrectomy?

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

For one week before your surgery, do not take aspirin, ibuprofen (such as Motrin or Advil), or any other nonprescription pain relievers except for acetaminophen (such as Tylenol). You may take acetaminophen for pain.

Follow any instructions your doctor 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?

A general anesthetic is given. It will relax your muscles and make you feel as if you are in a deep sleep. It will prevent you from feeling pain during the operation.

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

In a simple nephrectomy the doctor 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 doctor then ties off the vein, artery, and ureter. If cancer is strongly suspected then a radical nephrectomy is performed to remove as much tumor and diseased tissue as possible.

What happens after the procedure?

You may be in the hospital for about 4 to 7 days and should avoid all heavy activity for the next 4 weeks. During the first 2 weeks after the operation you may be able to do some light work. In the following 6 to 8 weeks you may be able to gradually do heavier work.

Ask your doctor what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

The kidney and its contents, such as stones, cancer, and/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 doctor.

• There is a risk of infection or bleeding.

• Your spleen, adrenal gland, and/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.

• The vein and artery connected to the kidney may form a connection between themselves and allow blood to flow from one to the other. If this happens they may need to be surgically separated.

• If your other kidney is not normal, then waste products may increase in your system and you may need dialysis.

• If you had cancer, not all of it may have been removed, and the cancer may grow back.

• Later in life you may not have enough kidney function and therefore need dialysis, a technique to separate waste products or toxins from the bloodstream.

Ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.

• You are in a lot of pain.

• You become unusually weak.

• The wound is leaking and/or bleeding.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.