Per urethra insertion of a through-and-through safety guide wire using a dual-lumen ureteral catheter during...

The second ("safety") of two guide wires is commonly inserted antegradely in percutaneous nephrolithotripsy (PCNL). We describe the retrograde insertion of a through-and-through safety guide wire during PCNL.

After inserting a percutaneous nephrostomy 1 day earlier, a guide wire was introduced through the nephrostomy tube to the bladder and pulled out through the urethral meatus via a cystoscope and grasper. The tube was removed, leaving the wire positioned from the flank to the meatus. A dual-lumen catheter was introduced retrogradely through the urethra over the wire, up to the nephrostomy incision. The safety guide wire was introduced retrogradely through the catheter's other port.

This procedure succeeded in 9 of 10 patients: the exception was very obese and the catheter was too short to reach the incision in the flank.

Using a dual-lumen catheter allows quick and simple retrograde insertion of a safety guide wire during PCNL.