[Percutaneous nephrostomy. Review of 92 cases]

Presentation of 92 nephrostomies percutaneous in 70 patients. Nephrostomy was bilateral in 5 cases. Three patients had collections of renal origin (2 urinomas and 1 abscess) which were treated percutaneously. The indication for nephrostomy was in all cases obstruction of the collector system, with one exception where the indication was ureteral fistula. Origin was lithiasis in 53 cases, 15 cases vesical carcinoma, 3 post-surgical iatrogenic stenosis, 1 fistula and formation of urinoma after lithotrity, 5 prostate carcinoma infiltration, 8 infectious origin, 4 congenital and 1 due to glandular cystitis. 9 patients were monorenal. In 6 patients leucocytosis was present, 4 has fever, and in 11 coexisted fever and leucocytosis. High creatinine and urea levels were present in 55.7% and 41% patients, respectively.. Renal puncture through lower calyceal group was the preferred option. Purulent urine was obtained in 17 cases. With regard to nephrostomy complications haematuria occurred in 30 cases (only in 9 it lasted more than 1 day); and there was 1 case of pararenal haematoma. Pain was significant in 12% procedures and contrast extravasation resulted in 14% cases (in all of them proper positioning of nephrostomy catheter was possible). Spontaneous expulsion and the subsequent replacement of the catheter occurred in 12 cases. On average, residence time of catheter was 44.8 days. In all cases both the patient's signs and symptoms, and the laboratory results were improved.