Abstract

This article highlights the indications, techniques, and complications of percutaneous nephrostomy. The authors' comments are based on their experience with more than 200 patients.

Highlights

  • Percutaneous nephrostomy (PCN) is a passageway that is introduced percutaneously into the renal pelvicalyces that can later be maintained by a tube, stent or catheter

  • Thanks to its good safety profile, percutaneous nephrostomy is the preferred technique for treatment of various urological conditions, and its pioneering role for relief of urinary tract obstruction remains in good use until today

  • This chapter aims to review the clinical use of percutaneous nephrostomy as well as the background technical aspects involved in carrying out the procedure

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Summary

Introduction

Percutaneous nephrostomy (PCN) is a passageway that is introduced percutaneously into the renal pelvicalyces that can later be maintained by a tube, stent or catheter. Following its introduction by Wickbom in 1954 who described percutaneous puncture of the renal pelvis as a diagnostic procedure, Goodwin and Casey first described its therapeutic use for relief of urinary tract obstruction the following year in 1955 (Goodwin, Casey et al 1955; Stables, Ginsberg et al 1978). Since this commonplace procedure has undergone significant progress in both its technical and imaging aspects, with improvisation of puncture devices and techniques, coupled with the advancing imaging modalities used to guide the procedure. The associated known complications of the procedure will be discussed, along with the therapeutic options available for the relevant complications

Indications and contraindications of percutaneous nephrostomy
Contraindications
Anatomical considerations
Patient preparations
Technique
Complications
Minor complications
Major complications
Hemorrhage
Sepsis
Pleural complications
Bowel transgression and colonic perforation
Injury to intra-abdominal viscera
Role of percutaneous nephrostomy in transplanted kidneys
Findings
Conclusion
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