Ultrasound Guided Direct Percutaneous Nephrostomy Tube Placement: Stepwise Report of a New Technique with Its Safety and Efficacy Evaluation

Abstract

Ultrasound guided Percutaneous Nephrostomy (PCN) tube placement: evaluation, safety and efficacy review. This was a quasi-experimental study conducted at Department of Urology, Regional Institute of Medical Sciences, Imphal. The total number of 176 patients with grade I-IV hydronephrosis requiring PCN tube placement were included in the study. Scientific, operational and accessory steps of the technique and its related safety and efficacy pre-procedural, intra-procedural and post-procedural parameters were carefully and meticulously recorded. Statistical analyses was performed using the Statistical Package for the Social Sciences (SPSS 16.0) for Windows. The average length of the procedure was 9.07±2.79 (6-15) minutes. Severe procedure related pain (VAS score 8-10) was observed only in 18 patients (10.23%). Nephrostomy tube placement was successful in 96.60% of cases and only 9.66% required more than a single attempt of puncture. In this study, impacted ureteric calculus was found to be most common indication of PCN tube placement. Ultrasound guided direct PCN tube placement is a reliable, easy and cost effective technique. This procedure is particularly suitable for developing countries like India, where the majority of the patients belongs to the low socio-economical status and health care system lacks adequate infrastructural facility at most places.