Percutaneous CT-Guided Nephrostomy: A Safe and Quick Alternative Method in Management of Obstructive and Nonobstructive Uropathy

Purpose: 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.Patients and 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.Conclusion: 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.