Transient ultrasound-guided percutaneous nephrostomy is kidney saving procedure

ABSTRACT

This study was conducted to present the outcome of the transient ultrasound-guided percutaneous nephrostomy [US-PCN] as a kidney saving procedure in cases with obstructive uropathy with or without ipsilateral infection. Between Jan 2000 and Jan 2009, 1283 transient percutaneous ultrasound-guided nephrostomy [unilateral or bilateral] were performed for 1105 patients. Patients were classified into three groups according to the main indications of PCN insertion. Group-I; 427 patients were suffering of obstructive uropathy and impaired renal function. In group-II, 522 PCN was performed for 516 patients with acute renal failure due to non-malignant obstructive uropathy. While in group-Ill, 162 patients with either pyonephrosis or infected hydronephrosis were urgently needed PCN drainage. The mean age was 51 +/- 4 years old [range 16-87 years old], 852 males [77.1%] and 253 females [22.9%]. Two techniques were used to achieve the proper drainage; the one-shot for clear urine or Seldinger for cases with turbid urine. Transient unilateral US-PCN was inserted in 927, while the other 178 cases nephrostomy were bilaterally [356] performed. Significant improvement was determined in 79% of the patients [P<0.005] one month after drainage and they scheduled for definitive management. The mean serum creatinine of all patients was significantly dropped [P<0.01] from 4.7 mg/dL to 1.3 mg/dL after one month of the renal drainage. Ultrasound-guided percutaneous nephrostomy was achieved without major complications in all patients apart of 3 cases with severe bleeding and 8 patients developed acute pyelonephritis. Transient PCN is a reliable, rapid, mostly easy, and effective method to save the kidney and it associated with low complications rate