Percutaneous Nephrostomy

Definition

A Percutaneous Nephrostomy is an interventional procedure performed under radiological guidance (ultrasound and fluoroscopy) to establish an artificial opening between the kidney and the skin. Its primary goal is to drain urine in cases of obstructive uropathy.

Pre-Procedure Checklist

Essential Requirements:

Coagulation study (INR < 1.5, Platelets > 50,000)
Signed informed consent
6 hours of fasting
Prophylactic antibiotic therapy

Step-by-Step Procedure

1

Access: Ultrasound-guided puncture of the renal collecting system (usually the lower or middle pole calyx).

2

Guidewire: Insertion of a metallic guidewire and confirmation of position via fluoroscopy.

3

Dilation: Sequential dilation of the percutaneous tract.

4

Catheter: Placement of the pigtail drainage catheter and securing it to the skin.

Common Complications

Hematuria: Common during the first 24-48 hours.
Infection/Sepsis: Risk due to mobilization of infected urine.
Catheter Dislodgement: Accidental removal or migration.
Pain: At the puncture site or renal colic symptoms.

Definition

Pre-Procedure Checklist

Step-by-Step Procedure

Common Complications