Percutaneous CT-guided nephrostomy: a safe and quick alternative method in management of obstructive and nonobstructive uropathy.
OBJECTIVE
To present the indications, technique, complications, and contraindications for CT-guided percutaneous nephrostomy (PCN) as an alternative to standard fluoroscopy-guided puncture that involves no radiation exposure for the radiologist.


METHODS
Between June 2000 and July 2004, 258 percutaneous CT-guided nephrostomies were performed in 215 patients in our department. Most patients (201; 93%) underwent PCN for obstructive uropathy, while 14 (7%) required the procedure as treatment for nonobstructive bladder trauma. All patients had subsequent insertion of a nephrostomy tube under CT guidance.


RESULTS
Percutaneous access was achieved without major complications in all patients. The most common complication was pain at the puncture site. In 50 patients (23%), the nephrostomy catheter remained in place until full decompression of the obstruction. In the 14 patients with bladder trauma, the catheter was removed after trauma repair. In 151 patients (70%), the catheter's placement was permanent.


CONCLUSIONS
Percutaneous CT-guided nephrostomy is a reliable, safe, fast, and highly effective method associated with a low complication rate that involves no radiation for the interventional radiologist.
Thanos
L
L
Radiology Department, Red Cross Hospital, Athens, Greece. loutharad@yahoo.com
Mylona
S
S
Stroumpouli
E
E
Kalioras
V
V
Pomoni
M
M
Batakis
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014514:Ureteral Calculi / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D014570:Urologic Diseases / Q000601:surgery*