What is the role of percutaneous nephrostomy in the treatment of nephrolithiasis?

Updated: Jun 21, 2018
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

In some cases, drainage of an obstructed kidney is necessary and stent placement is inadvisable or impossible. In particular, such cases include patients with pyonephrosis who have a UTI or urosepsis exacerbated by an obstructing calculus. In these patients, retrograde endourological procedures such as retrograde pyelography and stent placement may exacerbate infection by pushing infected urinary material into the obstructed renal unit. Percutaneous nephrostomy is useful in such situations. [71] If retrograde stent placement is determined to be more appropriate, attempts to minimize additional pressurization of the collecting system by using minimal contrast and or decompressing prior to contrast administrating should be employed.


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