Tolerance to Bilateral Subcutaneous Access Nephrostomy in Dogs

Abstract

Subcutaneous nephrostomy is a technique which allows access to the renal pelvis for physiological study in the experimental animal over a prolonged period of time without the complications attendant upon an externally draining appliance. One end of an 8 Fr. polyvinyl tube was placed in the renal pelvis at open surgery and the other end was capped and buried in the subcutaneous space for subsequent access by percutaneous needle puncture. This procedure is preferable to surgically created vesical exstrophy, exteriorization of the renal pelvis or conventional nephrostomy, techniques which have been proposed for such purposes. Tolerance to subcutaneous access nephrostomy was investigated in a group of 10 dogs followed for periods ranging from six months to two years. It was found that bilateral subcutaneous access nephrostomy did not alter kidney function but was associated with altered peristalsis. It was also associated frequently with bacteriuria, but not pyelonephritis. Neither calcific deposits nor calculi were seen as a consequence of the tube, and the procedure was well tolerated by the animal although, in some, progressive weight loss was observed. In general, this technique proved to be an excellent procedure for prolonged physiological studies of the urinary tract in dogs, and might similarly find some clinical application in humans.