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Upper tract urokinase instillation for nephrostomy tube patency
S E Pautler1, P Luke, J L Chin
1Division of Urology, University of Western Ontario, London, Canada.
Purpose:
We describe a useful technique for declotting a nephrostomy tube blocked secondary to recurrent blood clot formation.
Materials And Methods:
Urokinase was instilled into the nephrostomy tube in a patient with a solitary kidney obstructed by malignancy on 2 separate occasions for 30 minutes each followed by manual irrigation with normal saline.
Results:
The nephrostomy tube and renal pelvis were successfully declotted, and we avoided a nephrostomy tube change or insertion of a second tube. The tumor was subsequently embolized to prevent further bleeding.
Conclusions:
Instillation of urokinase into a nephrostomy tube blocked by a blood clot may obviate repeat nephrostomy tube changes and is a useful addition to the urological armamentarium.