Complications associated with percutaneous nephrostomies. A retrospective study

To determine the morbidity and mortality associated with radiologically guided percutaneous nephrostomy (PCN).

A retrospective analysis of 401 patients treated with 569 PCN over a 5-year period was performed. Using the Seldinger technique, the catheters (6-10 F) were placed under fluoroscopic, ultrasonographic, or CT guidance. Data on underlying disease, complications, subsequent management, and long-term management were collected.

PCN was successful in 558 of the 569 attempts (98%). There were 22 major complications (4%) in 569 procedures, including cardiac arrest, bleeding requiring transfusion or embolization, septicemia, hydrothorax or pneumothorax. There were 38% minor complications, including urinary tract infection, catheter dislodgement, catheter obstruction by debris, urinary leakage, and inflammation of the skin at the site of insertion of the percutaneous catheter. Seventy-seven (14%) of the procedures were followed by urinary tract infection during the PCN treatment. Seventy-nine (14%) catheters slipped out unintentionally.

Percutaneous nephrostomy is a gentle procedure associated with high technical success and low morbidity. However, the risk of the procedure has to be weighed against the expected benefit.