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Jairath et al. Mini-invasive Surg 2017;1:180-5 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.24
www.misjournal.net
Technical Note Open Access

Percutaneous nephrostomy step by step

Ankush Jairath , Arvind Ganpule , Mahesh Desai 3
1
2
1 Urology, Muljibhai Patel Urological Hospital, Gujarat 387001, India.
2 DNB (Diplomat of national board), Urology, Muljibhai Patel Urological Hospital, Gujarat 387001, India.
3 Department of Urology and Renal Transplant, Muljibhai Patel Urological Hospital, Gujarat 387001, India.
Correspondence to: Dr. Arvind Ganpule, DNB (Diplomat of national board), Urology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat 387001, India.
E-mail: doctorarvind1@gmail.com
How to cite this article: Jairath A, Ganpule A, Desai M. Percutaneous nephrostomy step by step. Mini-invasive Surg 2017;1:180-5.

ABSTRACT
Article history: Percutaneous renal access remains the cornerstone initial step in varied clinical settings. For
Received: 10 Jul 2017 obtaining the best surgical outcome and minimizing patient morbidity, an appropriate access
First Decision: 1 Sep 2017 to the target calyx is needed. Though the site of entry depends upon anatomy of pelvicalyceal
Revised: 30 Sep 2017 system and indication for access, a proper technique should be used for gaining access and at
Accepted: 11 Oct 2017 the same time minimizing the associated complications. This article describes our technique
Published: 28 Dec 2017 of gaining access to the pelvicalyceal system and subsequent percutaneous nephrostomy
placement in a stepwise manner.
Key words:
Percutaneous nephrostomy,
ultrasound,
hydronephrosis

INTRODUCTION (USG) or computed tomography guidance. In this
chapter we will describe the USG guided technique of
Percutaneous nephrostomy (PCN) is a widely used PCN placement in a stepwise manner which is safe,
interventional procedure for upper urinary diversion effective and easily reproducible.
and decompression of the renal collecting system
in varied clinical settings. Despite it being a basic INDICATION FOR PCN
urological procedure, it remains technically challenging
to insert it in the right way and in the right place. Most Obstructive uropathy
of the time it’s because of lack of exposure of the Benign causes: impacted ureteric/pelvis calculi with
urologist/interventional radiologist to correct technique secondary hydronephrosis (HN), uretericstricture
of PCN placement in a stepwise manner. Goodwin et al. disease, pelvic ureteric junction obstruction, HN
[1]
first reported placement of percutaneous trocar associated with pregnancy, in transplant patients
(needle) nephrostomy in a hydronephrotic kidney. (e.g. HN due to anastomotic stricture), retroperitoneal
Since then, many direct and wire guided methods fibrosis, urosepsis, pyonephrosis. Malignant causes:
of PCN placement has been elucidated in literature. HN secondary to tumor of urinary tract, HN secondary
PCN can be done under flouroscopy, ultrasound to carcinoma cervix/prostate [2,3] .

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