[Percutaneous nephrostomy--the method and technical problems].

Ultrasound guided percutaneous nephrostomy (PNS) was performed on 72 patients (80 kidneys) including pretreatment for percutaneous nephro-uretero lithotomy (PNL). PNS was performed for post-renal anuria or hydronephrosis in 23 cases (28 kidneys), for urinary leakage in 4 cases (5 kidneys), for vesical bleeding in 1 case (2 kidneys) and as pretreatment of PNL in 44 cases (45 kidneys). Ultrasound guided renal puncture was done percutaneously and a 0.038 inch J-tipped wire guide was inserted into the suitable calyx. Then the nephrostomy tract was dilated with fascia dilators of Malecot nephrostomy set. A 14 Fr or 16 Fr Malecot catheter was used for hydronephrosis or urinary leakage cases. 18 Fr, 24 Fr Malecot catheter or Bardex balloon catheter 18-22 Fr was inserted for PNL cases. In the PNL group, Ht decreased slightly but there was no need of blood transfusion. In the other groups, Ht did not change. Defect of 99m-Tc-DMSA renal uptake in several cases suggested renal injury at nephrostomied cortex. In about 70% of the cases, a fever of more than 37 degrees C was observed, and in 4 cases, more than 39 degrees C was observed. There were no major complications observed. In conclusion, percutaneous nephrostomy using Malecot nephrostomy set is a safe and effective method.