[Drainage (prosthesis) of the pyelocaliceal system]

Of 372 patients, treated in the Clinical Center of Urology-Sofia, and sixteen patients treated in the urological clinic at the Military Medical Academy-Sofia, in 241 cases various types of polyethylene drainage systems and prostheses are used, classified into two basic groups: intraoperative prosthetic replacement, and therapeutic prosthetic replacement. Intraoperative prosthetic replacement of the pyelocaliceal system reduces intrarenal pressure, promotes uneventful operative wound healing, precludes obstruction due to the so-called sterile edema at the site of operation, and serves as a drainage and splint; nephrostoma is indicated in selected cases against the background of additional complications, whereas prosthetic replacement during endourologic manipulations is mandatory. The complications associated with prosthetic replacement of the pyelocaliceal system are rare, and lend themselves readily to nonoperative treatment, but in isolated cases surgical intervention is necessitated.