Ultrasound-guided percutaneous nephrostomy performed by urologists: 10-year experience

Abstract

Objectives To assess the safety, feasibility, and effectiveness of percutaneous nephrostomy tube (PNT) insertion performed solely by a urologist on an outpatient basis. We present our relevant 10-year experience. Methods From 1996 to 2005, 650 PNT insertions were performed in 530 patients (356 men and 174 women), aged 39 to 94 years (mean 67.4). All patients were referred to our outpatient department. PNT placement was performed under local anesthesia by a consultant urologist or registrar during regular work hours or during on-call duty. Early complications within 30 days of PNT insertion were recorded. Results Primary successful PNT insertion was recorded in 615 (94.6%) of the 650 procedures. Follow-up data up to 30 days were available for 545 PNT placements (83.8%). Of the 650 PNT insertions, 22 (3.3%) major immediate complications were encountered. In 4 patients, laparotomy was performed for surgical exploration of hemorrhage (3 patients) or choleperitoneum, resulting in nephrectomy (1 patient). In 5 (0.8%) of 615 successful PNT procedures, we recorded septicemia, which resulted in 2 deaths. In 1 more case (0.1%), the nephrostomy tube was misplaced into the inferior vena cava. Minor complications within the follow-up period were recorded in 24 (4.5%) of 545 cases. The complication rate did not differ significantly between the consultants and registrars or whether PNT insertion was performed during regular work hours or during on-call duty. Conclusions Ultrasound-guided PNT insertion performed solely by a urologist is a safe, feasible, and efficient procedure, regardless of the operator’s experience.