[Complications of percutaneous nephropyelostomy with special reference to the sonographic real-time puncture technic]

99 ultrasonographically-guided percutaneous nephropyelostomies (PNP) were done in 77 patients. Average age at operation was 60 years, most often PNP was done in cancer patients. In 26 cases compound-scanning technique and in 73 cases real-time technique was used. Real-time ultrasound imaging of the kidney is superior to compound-scan technique and allows dynamical imaging of percutaneously introduced canulas. Thus guidance of puncture technique and security of reaching the calix system have been optimized. Correct placement of nephrostomy catheter was achieved in 88.5% using compound-scanning technique compared to 92% using real-time ultrasonography. Moreover puncture of the calix system by needle was successful in every case using real-time ultrasonography. Complication rate was 2%. In one patient the calix system was perforated and one with macrohematuria required open surgery. Real-time ultrasound technique enables us to perform controlled percutaneous nephropyelostomy easily without hazardous complications.