Percutaneous nephrostomy and antegrade ureteral stenting: technique-indications-complications

In this review the technique, indication for and complications of percutaneous nephrostomy (PCN) and antegrade ureter stent insertion are described. In the majority of the cases PCN is performed to relieve urinary obstruction, which can be of benign or malignant nature. Another indication for PCN is...

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Bibliographic Details
Published in:European radiology 2006-09, Vol.16 (9), p.2016-2030
Main Authors: Hausegger, Klaus Armin, Portugaller, Horst Rupert
Format: Article
Language:English
Subjects:
Carbon dioxide
Catheters
Catheters, Indwelling
Fluoroscopy
Humans
Implants
Indication
Insertion
Medical imaging
Nephrostomy, Percutaneous - adverse effects
Nephrostomy, Percutaneous - instrumentation
Nephrostomy, Percutaneous - methods
Obstructions
Sinuses
Stents
Ultrasonic imaging
Ureter
Urinary tract
Urine
Urologic Diseases - surgery
Veins & arteries
Wire
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Description
Summary:In this review the technique, indication for and complications of percutaneous nephrostomy (PCN) and antegrade ureter stent insertion are described. In the majority of the cases PCN is performed to relieve urinary obstruction, which can be of benign or malignant nature. Another indication for PCN is for treatment of urinary fistulas. PCN can be performed under ultrasound and/or fluoroscopic guidance, with a success rate of more than 90%. The complication rate is approximately 10% for major and minor complications together and 4-5% for major complications only. Percutaneous antegrade double-J stent insertion usually is performed if retrograde ureter stenting has not been successful. However, especially in malignant obstructions, the success rate for antegrade stenting is higher than for retrograde transvesical double-J stent insertion. In the case of severe infection and bleeding after PCN JJ-stent insertion may be contraindicated so long as there is no sufficient concomitant drainage via a PCN . Lower urinary tract dysfunction should be excluded before stent placement. The complication rate is 2-4%. Consequent stent surveillance with regular stent exchange is mandatory.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-005-0136-7