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Urologist directed percutaneous nephrostomy tube placement
K G Mahaffey1, D M Bolton, M L Stoller
1Department of Urology, University of California, San Francisco 94143-0738.
The Journal of Urology
|December 1, 1994
Summary
Urologists can safely insert percutaneous nephrostomy tubes, with low rates of immediate complications like sepsis or hemorrhage. Delayed issues such as dislodgement or occlusion occurred in 21% of cases, independent of tube type.
Area of Science:
- Urology
- Interventional Radiology
Background:
- Percutaneous nephrostomy (PCN) is a common urological procedure.
- Urologists typically manage PCN tube placement indications and subsequent endourological manipulations.
Purpose of the Study:
- To evaluate the safety and complication rates of ultrasonically guided PCN tube insertion performed by urologists.
- To assess the incidence of both immediate and delayed complications associated with PCN tubes.
Main Methods:
- Retrospective analysis of 100 consecutive PCN tube insertions.
- Procedures were guided by ultrasonography and performed by urologists.
- Complications were categorized as immediate (during insertion) or delayed (post-insertion).
Main Results:
- Immediate complications occurred in 6% of cases (sepsis 3%, renal pelvic perforation 2%, hemorrhage 1%), with no deaths or need for open surgery.
- Delayed complications (malfunction >24 hours post-insertion) occurred in 21%, including dislodgement (11%) and occlusion (6%).
- Delayed complication rates were not dependent on the type of nephrostomy tube used.
Conclusions:
- Ultrasonically guided PCN tube insertion by urologists is a safe procedure with a low incidence of immediate complications.
- Delayed tube malfunctions are relatively common and warrant attention.
- Given their role in PCN management, urologists should play a more significant part in catheter insertion.