TO ACCESS THE ROLE OF PERCUTANEOUS NEPHROSTOMY IN THE MANAGEMENT OF URETERIC OBSTRUCTION

Percutaneous nephropyelostomy or nephropyeloplasty, is an interventional procedure that is used mainly in the decompression of the renal collecting system. Urinary obstruction can be caused by variety of aetiologies in any age group. Frequently, the obstructed system becomes infected, and antibiotics are unable to penetrate the kidney. In these cases, percutaneous nephrostomy is an attractive treatment alternative because it allows decompression of obstructed system. AIMS AND OBJECTIVES: Ÿ To assess the various indications of percutaneous nephrostomy in our institute. Ÿ To assess the impact on renal function tests in various urological disease for which percutaneous nephrostomy is done. Ÿ To assess complications associated with percutaneous nephrostomy. MATERIAL AND METHODS: The study was conducted in the post graduate department of surgery, GMC Jammu from December 2012 to November 2013. SELECTION CRITERIA: Ÿ Patients with supravesical obstruction i.e. due to stone disease, tumours associated with sepsis and azotemia. Ÿ Ureteropelvic junction obstruction Ÿ Ureteric tumour Ÿ Ureterovaginal fistula Ÿ Diversion in cases of haemorrhagic cystitis Ÿ Genitourinary tuberculosis EXCLUSION CRITERIA: Ÿ Patients with bleeding disorders. Ÿ Patients on anticoagulants Conclusion 1. Urinary stone disease is the most common etiological factor for percutaneous nephrostomy followed by carcinoma cervix and carcinoma urinary bladder. 2. Percutaneous nehrostomy when performed properly has 100% technical success rate. 3. Ultrasonography is usually first imaging procedure performed for the status of upper urinary tract and possible etiology. Percutaneous nephrostomy is very useful in normalising the deranged renal functions in case of obstructive uropathy after which definitive procedure is carried out.