Percutaneous nephrostomy for nondilated renal collecting system with ultrasound and fluoroscopic guidance: The results of a 10-year experience

Abstract

PURPOSE This study aimed to evaluate the technical success rate, complications, and radiation doses of ultrasound- and fluoroscopy-guided percutaneous nephrostomy (PCN) in patients with a nondilated renal collecting system. METHODS Over a 10-year period, 50 patients were referred for PCN of 60 kidneys with a nondilated renal collecting system. The patients included 22 males and 28 females with a mean age of 63.2 years (range: 35-87 years). The most common reason for PCN in these patients was postoperative ureteral leaks and/or fistula (21/50 patients). PCN was performed under ultrasound and fluoroscopic guidance. During PCN, intravenous contrast media or diuretics were not used. Technical success rate, complications, procedure time, and radiation exposure of the procedure were retrospectively evaluated. RESULTS Ultrasound- and fluoroscopy-guided PCN for nondilated renal collecting system showed a success rate of 83.3% (50/60 kidneys) in the initial attempt. Four PCNs were repeated and were successful after the initial PCN failure. There was 1 major complication of bleeding that required transfusion in 1.9% (1/54) PCNs and there were minor complications of transient gross hematuria through the PCN catheter in 31.5% (17/54) PCNs. Mean duration of the procedure was 15.97 +/- 7.81 min and median fluoroscopy time was 4.2 min (range: 1.2-15.3 min). Median dose area product and cumulative dose were 345.37 mu Gy center dot m(2) (range: 42.57-1659.76 mu Gy center dot m(2)) and 46.9 mGy (range: 7.7-267.8 mGy), respectively. CONCLUSION Ultrasound- and fluoroscopy-guided PCN for nondilated renal collecting system was feasible with acceptable technical success rate, complication rate, procedure time, and radiation exposure.