Complications associated with percutaneous nephrostomies. a retrospective study

Abstract

Purpose: To determine the morbidity and mortality associated with radiologically guided percutaneous nephrostomy (PCN). Material and Methods: A retrospective analysis of 401 patients treated with 569 PCN over a 5‐year period was performed. Using the Seldinger technique, the catheters (6–10 F) were placed under fluoroscopic, ultrasonographic, or CT guidance. Data on underlying disease, complications, subsequent management, and long‐term management were collected. Results: PCN was successful in 558 of the 569 attempts (98%). There were 22 major complications (4%) in 569 procedures, including cardiac arrest, bleeding requiring transfusion or embolization, septicemia, hydrothorax or pneumothorax. There were 38% minor complications, including urinary tract infection, catheter dislodgement, catheter obstruction by debris, urinary leakage, and inflammation of the skin at the site of insertion of the percutaneous catheter. Seventy‐seven (14%) of the procedures were followed by urinary tract infection during the PCN treatment. Seventy‐nine (14%) catheters slipped out unintentionally. Conclusion: Percutaneous nephrostomy is a gentle procedure associated with high technical success and low morbidity. However, the risk of the procedure has to be weighed against the expected benefit.