Ultrasound-guided percutaneous nephrostomy: Analysis of early complications in a prospective descriptive cross-sectional study at a tertiary care center

Abstract

Background: Percutaneous nephrostomy (PCN) is a crucial intervention for urinary obstruction. Understanding indications, complications, and materials used enhances its clinical application. Objective: This study aims to identify PCN indications, assess tube types/materials, evaluate early complications, and determine PCN success rates, fostering improved outcomes and procedural refinement. Materials and Methods: This study was carried out in the interventional radiology suite of the Department of Radiodiagnosis and Imaging, Tribhuvan University Teaching Hospital (TUTH) on 74 patients for one year. Patients of all age groups who underwent PCN were included in the study. Indications for PCN were identified before the procedure using various imaging modalities like Ultrasonography (USG), Computed Tomography (CT) scan, and more. The type of approach, calyx punctured, the size of the tube chosen, and the type of the drain material were all recorded during the procedure or in the post-procedure note. The patients were evaluated daily, and USG was done in every patient after 48 hours of the procedure to evaluate in terms of any complications. Results: Ninety-eight PCNs were done on 74 patients, of whom 58 were males and 40 were females. The main reasons for PCN were calculus disease with hydronephrosis (44.9%), calculus disease with pyonephrosis (22.4%), and obstructive uropathy due to bladder or cervix carcinoma. The success rate for PCN on the first attempt was 89.8%, while 6.1% required two attempts and 4.1% needed more than two attempts. Complications included tube dislodgement (8.2%), urinoma (5.1%), major bleeding (3%), and retroperitoneal hematoma (1%). No new cases of sepsis occurred post-procedure. Conclusion: Percutaneous nephrostomy is a safe and simple procedure with low morbidity and no life-threatening complications.