Percutaneous translumbar pyelography: a presentation of 11 cases

Percutaneous antegrade pyelography in children

We report our experience with 107 percutaneous antegrade pyelograms in 79 children aged between 3 days and 14 years. The main indications for the procedure are outlined, together with a note on the technique. Puncture of the pelvicaliceal system failed in 10% of cases. The procedure is simple to perform and is preferred to retrograde urography, which carries significant morbidity and is impracticable in the male infant. Antegrade pyelography provides the definitive anatomical diagnosis of obstruction of the upper urinary tract. It is particularly useful in megaureters after reimplantation and in grossly dilated and/or poorly functioning systems where diagnosis of obstruction by radionuclide renal scan could be difficult. The procedure has been found to be safe and complications are minimal.

Percutaneous needle nephrostomy

Percutaneous nephrostomy is a simple technique for temporary drainage of an obstructed kidney. Under local anaesthesia a ureteric catheter is passed through a Vim-Silverman needle into the renal pelvis and is connected to a drainage bag. Seven cases (six successful) in which this method was used are described and the indications are discussed. It has been free from complications, is acceptable to patients, and is felt to represent a useful addition to the methods available for the treatment of obstruction of the upper urinary tract.