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(B) The pigtail catheter is placed in the dilated calyx. The tube in (A) and the pigtail in (B) are marked with white arrows. [1] A nephrostomy or percutaneous nephrostomy is an artificial opening created between the kidney and the skin which allows for the urinary diversion directly from the upper part of the urinary system (renal pelvis). [2]
Treatment of hydronephrosis focuses on the removal of the obstruction and drainage of the urine that has accumulated behind the obstruction. Therefore, the specific treatment depends upon where the obstruction lies. [14] Acute obstruction of the upper urinary tract is usually treated by the insertion of a nephrostomy tube.
The insertion of a drainage tube into the renal pelvis, bypassing the ureters and urinary tract, called nephrostomy, was first described in 1941. Such an approach differed greatly from the open surgical approaches within the urinary system employed during the preceding two millennia. [10]
-ectomy : surgical removal (see List of -ectomies). The term 'resection' is also used, especially when referring to a tumor.-opsy : looking at-oscopy : viewing of, normally with a scope-ostomy or -stomy : surgically creating a hole (a new "mouth" or "stoma", from the Greek στόμα (stóma), meaning "body", see List of -ostomies)
Percutaneous nephrostomy: A nephrostomy is created when the flow of urine is diverted directly from the kidneys to the abdominal wall. Tubes are placed within the kidney to collect the urine as it is generated, and transport it to the abdominal wall. This procedure is usually temporary; however, it may be permanent for cancer patients.
Percutaneous nephrolithotomy (PCNL) is a minimally-invasive procedure to remove stones from the kidney by a small puncture wound (up to about 1 cm) through the skin. It is most suitable to remove stones of more than 2 cm in size and which are present near the pelvic region.
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The gold standard of treatment for these types of stones is surgical removal. However, some patients have an infected stone and are simply too ill for an operative surgical removal. In these instances, the mainstay of IR treatment is a percutaneous nephrostomy tube. [ 24 ]