[A different approach to the percutaneous nephrostomy by urologists]

Easy Method for Percutaneous Nephrostomy Placement with Transrectal Ultrasonography Probe

Aim: Percutaneous nephrostomy (PN), the indispensable interventional procedure in situations such as obstructive uropathy and pyonephrosis, requires serious experience. As a result, many urologists and radiologists avoid this procedure. However, this can leave both doctor and patient in a difficult situation when it is necessary. In this study, we aimed at presenting a nephrostomy insertion technique by using a transrectal ultrasonography probe that we use in our clinic and we believe that this has made the PN procedure easier, along with our results. Patients and Methods: Data from patients with PN inserted by using this method at our clinic from January 2013 to December 2018 were retrospectively scanned. The nephrostomy indications, complications, and success rates for patients were assessed. All procedures were performed under local anesthesia without the help of a radiologist. Results: A total of 84 patients, 55 male and 29 female, had 146 nephrostomy catheters inserted. Nephrostomy was performed in 52 patients due to obstruction linked to malignancy and in 32 patients due to reasons other than malignancy. The procedure was successfully concluded in all patients independent of degree of hydronephrosis. Conclusion: With our technique, PN was found to be performed easily with low complication rates.

How can I get a renal access if I do not have an ultrasound and cannot opacify the collecting system? Another use of the hydrophilic guide wire

It is well-known that fluoroscopic guidance is the most commonly used imaging technique for percutaneous access to the kidney. However, we might encounter difficulties when attempting to establish the limits of the collecting system for a percutaneous puncture, especially in places where the use of ultrasound guidance in the operating room is limited. We aim to describe the use of a hydrophilic guide wire to delimit the collecting system when this becomes difficult with conventional techniques.