The results of ultrasound-guided percutaneous nephrostomy tube placement for obstructive uropathy: A single-centre 10-year experience

The aim of this study was to determine the results of ultrasound-guided percutaneous nephrostomy tube placement performed solely by urologists. We present our relevant one decade experience in a tertiary care hospital.

We evaluated technical success and complication rates of ultrasound-guided percutaneous nephrostomy tube placement for obstructive uropathy in our clinic, between December 2004 and January 2015. Data were retrieved retrospectively from patients' files. This procedure was performed by urologists and two different methods for renal access were employed: Seldinger technique and direct puncture technique. Percutaneous nephrostomy tube placement was considered successful if the tube was placed in the renal pelvis and drained urine spontaneously and adequately. Complications were classified according to the Guideline of Society of Interventional Radiology Guidelines for Percutaneous Nephrostomy.

Four hundred and fifteen percutaneous nephrostomy tube placements were performed in 354 patients (165 men and 159 women) suffering from obstructive uropathy due to several benign (57.3%) or malign (42.7%) diseases. The mean age in this study group was 43.2 years (range 27 to 81). We were found that 228 procedures were performed by using the Seldinger technique and 187 using direct puncture technique. The overall technical success, major and minor complications rates were 96.1%, 11.1%, and 7.7%, respectively. The Seldinger technique and direct puncture technique were compared: technical success rate was 97.8% vs. 94.1% (p=0.052). There was no difference between the two techniques in terms of major and minor complication rates.

Ultrasound-guided percutaneous nephrostomy tube placement is a safe, easy and effective technique for providing temporary or permanent drainage of an obstructed renal pelvi-calyceal system. This procedure can be performed effectively and safely by an urologist.