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Complications of ultrasound-guided nephrostomy. A 5-year experience
P von der Recke1, M B Nielsen, J F Pedersen
1Department of Radiology, Glostrup Hospital, University of Copenhagen, Denmark.
Abstract:
In a 5-year period (January 1987 to December 1991) a total of 285 US-guided nephrostomy procedures were performed in 159 patients. All nephrostomies were performed with a 2.3 mm one-step trochar catheter without internal fixation. The hospital case records were reviewed retrospectively, and complications were registered. The overall success rate was 92%. The catheters were maintained for a median of 17 days (range 1-150 days). Thirty-three catheters slipped out unintentionally in the first 10 days. Haematuria through the catheter for more than 3 days occurred in 14 cases. Complications occurred in 19 (6.7%) of the procedures. One uraemic patient had cardiac arrest but was resuscitated. Two patients had severe haematuria and one of them had a nephrectomy. Seven patients developed septicaemia, and 6 had perirenal bleeding or urinary leakage. Three patients developed skin infection. Ultrasound-guided nephrostomy is a gentle procedure with only few major complications, but the risk of the procedure should still be weighed against the expected benefit.
Insights
Ultrasound-guided nephrostomy is a safe and effective procedure with a 92% success rate. While complications are rare (6.7%), careful patient selection is crucial to weigh risks against benefits.
Area of Science:
- Urology
- Radiology
- Minimally Invasive Procedures
Background:
- Nephrostomy is a common procedure for urinary tract drainage.
- Minimally invasive techniques aim to reduce procedural risks and improve patient outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of ultrasound-guided nephrostomy.
- To assess the complication rates associated with this technique.
Main Methods:
- Retrospective review of 285 ultrasound-guided nephrostomy procedures in 159 patients.
- Procedures performed using a 2.3 mm one-step trochar catheter without internal fixation.
- Complications were systematically registered.
Main Results:
- Overall success rate of 92%.
- Catheter indwelling time ranged from 1 to 150 days (median 17 days).
- Complication rate was 6.7%, including unintentional catheter dislodgement, prolonged hematuria, sepsis, perirenal bleeding, urinary leakage, and skin infection. One patient required nephrectomy due to severe hematuria.
Conclusions:
- Ultrasound-guided nephrostomy is a gentle procedure with a low rate of major complications.
- The benefits of the procedure should be carefully weighed against potential risks for each patient.