| 1. Goodwin WE, Casey WC, Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc. 1955;157(11):891-894. |
Review/Other-Tx |
16 patients |
To describe indications for and the technique and results of trocar nephrostomy in selected cases of hydronephrosis. |
Trocar nephrostomy may be a useful method of temporary urinary diversion. Further evaluation of technique is needed. |
4 |
| 2. Ali SM, Mehmood K, Faiq SM, Ali B, Naqvi SA, Rizvi AU. Frequency of complications in image guided percutaneous nephrostomy. JPMA J Pak Med Assoc. 63(7):816-20, 2013 Jul. |
Review/Other-Tx |
300 patients |
To assess the frequency of complications in image-guided percutaneous nephrostomy and to identify common sources of error. |
Three hundred patients enrolled in the study. The procedure was successful in all encounters. The complications were categorised as early and late complications. Early complications were sepsis in 6 (2%) patients, retroperitoneal haematoma in 5 (1.6%) patients, bleeding in 2 (0.6%), and urinoma in 1 (0.3%). Late complications included catheter blockage in 15 (5%) patients, and dislodgement of catheter in 7 (2.3%). Total early complications were noted in 14 (4.66%) patients, and there were 22 (7.33%) late complications. |
4 |
| 3. Hawkins IF, Jr. Retrograde percutaneous nephrostomy. Crit Rev Diagn Imaging. 1987;27(2):153-165. |
Review/Other-Tx |
Over 200 cases |
Describe retrograde PCN. Retrograde approach was used in over 200 cases without any complications directly attributable to the nephrostomy. |
Retrograde approach is safer, more reliable and less time consuming than the antegrade approach, especially in nondilated pelvicalyceal system. |
4 |
| 4. Barton DP, Morse SS, Fiorica JV, Hoffman MS, Roberts WS, Cavanagh D. Percutaneous nephrostomy and ureteral stenting in gynecologic malignancies. Obstet Gynecol. 1992;80(5):805-811. |
Observational-Tx |
40 patients |
Retrospective study to identify the indications, complications, and efficacy of PCNs and ureteral stents in women with gynecologic cancer. |
Renal function was abnormal in 26 patients. Abnormal renal function improved in 14/26. Median survival was 5.5 months. Techniques are safe and often improve renal function. |
2 |
| 5. Coddington CC, Thomas JR, Hoskins WJ. Percutaneous nephrostomy for ureteral obstruction in patients with gynecologic malignancy. Gynecol Oncol. 1984;18(3):339-348. |
Review/Other-Tx |
6 cases |
To describe the role of PCN in malignant gynecological obstructions using six illustrative cases. |
Nonoperative technique of PCN allows placement of either an external nephrostomy tube or an IUS under local anesthesia. |
4 |
| 6. Culkin DJ, Wheeler JS, Jr., Marsans RE, Nam SI, Canning JR. Percutaneous nephrostomy for palliation of metastatic ureteral obstruction. Urology. 1987;30(3):229-231. |
Review/Other-Tx |
27 patients |
To evaluate the role of PCN for palliative decompression in malignant ureteric obstruction. |
Improved survival and less morbidity compared with historical open decompression. Patients with prostate, rectal and cervical cancers have best survival. Mean survival of all patients was 6.63 months (n=19). |
4 |
| 7. Lynch MF, Anson KM, Patel U. Current opinion amongst radiologists and urologists in the UK on percutaneous nephrostomy and ureteric stent insertion for acute renal unobstruction: Results of a postal survey. BJU Int. 2006;98(6):1143-1144. |
Review/Other-Tx |
153 radiologists and 132 endourologists |
Results of a postal survey to identify the current opinions of radiologists and urologists in the UK on PCN and ureteric stent insertion for acute renal unobstruction. Questionnaire was sent to 153 radiologists and 132 endourologists. |
There were areas of strong consensus, as in clinical scenarios of ‘clinical sepsis’ or ‘elevated creatinine and potassium’, where there was 90%–100% agreement amongst all clinicians on the need for unobstruction. However, when considering, (eg, ‘ureteric obstruction with hydronephrosis with advanced malignancy for palliation’) only half of all respondents thought that unobstruction was indicated, highlighting the difficulties faced in this contentious scenario. The strongest divergence was that urologists favored PCN more often than radiologists (mean, median and range of percentage preference for PCN were 48% vs 69%, 49% vs 74%, and 6%-100% vs 18%-100% for radiologists vs urologists, respectively; P<0.001, unpaired t-test). Stents were preferred by urologist only in patients with uncomplicated benign disease and in those with coagulopathy. |
4 |
| 8. Chitale S, Raja V, Hussain N, et al. One-stage tubeless antegrade ureteric stenting: a safe and cost-effective option?. Ann R Coll Surg Engl. 92(3):218-24, 2010 Apr. |
Review/Other-Tx |
98 patients |
To assess the outcome of primary, one-stage antegrade ureteric stenting and to compare its safety and efficacy with the conventional two-stage approach. |
A one-stage approach was found to be suitable in most cases with many advantages over the two-stage approach with comparable or better outcomes at lower costs. |
4 |
| 9. Dauw CA, Faerber GJ, Hollingsworth JM 3rd, Wolf JS Jr. Wire-reinforced ureteral stents to rescue from nephrostomy tube in extrinsic ureteral obstruction. Can J Urol. 22(3):7806-10, 2015 Jun. |
Experimental-Tx |
8 patients |
To evaluate a novel, wire-reinforced internal ureteral stent as an alternative to percutaneous nephrostomy (PCN) in those patients who fail initial internal ureteral stent placement. |
A total of 8 patients were identified with extrinsic ureteral obstruction that failed initial conventional ureteral stenting and had a Scaffold stent placed. Scaffold stents ultimately failed in 3 out of 8 patients. Mean time to Scaffold stent failure was 197 days (range 20-536). In the remaining 5 patients, mean failure-free time with Scaffold stents in place was 277 days (range 18-774). |
3 |
| 10. Modi AP, Ritch CR, Arend D, et al. Multicenter experience with metallic ureteral stents for malignant and chronic benign ureteral obstruction. J Endourol. 24(7):1189-93, 2010 Jul. |
Review/Other-Tx |
76 stents in 59 renal units (40 patients) |
To review the clinical experience with this stent for malignant or benign chronic ureteral obstruction. |
Creatinine value follow-up on 54 renal units showed 20 (37%) units to have stable, 15 (28%) improved, and 19 (35%) with worsening values. No stent showed encrustation on plain radiography despite it being seen on two during direct visualization. Three stents needed operative removal with either percutaneous nephrolithotomy or cystolitholapaxy. 15/41 (37%) metallic stents placed because of an obstructed plastic stent also became obstructed. At last follow-up, 6 of 40 patients were kept from nephrostomy tubes because of the metallic stent. |
4 |
| 11. Varnavas M, Bolgeri M, Mukhtar S, Anson K. The Role of Tandem Double-J Ureteral Stents in the Management of Malignant Ureteral Obstruction. J Endourol. 30(4):465-8, 2016 Apr. |
Observational-Tx |
15 patients |
To report our experience with the use of twin ureteral stents (TUSs) in the management of malignant ureteral obstruction (MUO). |
Twenty-two TUS insertion procedures were performed on 15 patients between the period of January 1,2006, and December 31, 2014. The mean patient age was 68.0 years (39–85 years). There were 15 primaryinsertions as well as 7 subsequent stent changes. The average prenephrostomy creatinine was 428 lmol/L; anaverage improvement of 196 lmol/L was observed after percutaneous drainage. Serum creatinine after TUSremained stable on discharge, 214 lmol/L vs 227 lmol/L preoperatively, p = 0.34. Eleven patients died at amedian 131 days post-TUS insertion. TUS failure occurred in three patients; this was characterized by risingcreatinine and worsening hydronephrosis. Patients with failing TUS had a median life expectancy of 45.6 dayscompared with 162.5 days for those with functioning TUS ( p < 0.05). Overall, the patency rate at 3 months was80%. |
2 |
| 12. Delvecchio FC, Kuo RL, Iselin CE, Webster GD, Preminger GM. Combined antegrade and retrograde endoscopic approach for the management of urinary diversion-associated pathology. Journal of Endourology. 14(3):251-6, 2000 Apr. |
Review/Other-Tx |
5 patients |
To describe management of diversion-associated pathology through a combined antegrade and retrograde endourologic approach, which provides rapid and safe access to the area of interest. |
The combined antegrade and retrograde approach allowed successful access to pathologic areas in all patients. Holmium laser/Acucise incision of stenotic segments or ballistic fragmentation of stones was achieved in all cases without perioperative complications. None of the strictures with an initially successfuloutcome has recurred; however, in one patient, the procedure failed as soon as the internal stent was removed. The patient with the ureteral calculus remains stone free, and his ureterosigmoidostomy is patent without evidence of obstruction on his last imaging study, 24 months postoperatively. |
4 |
| 13. el-Nahas AR, Eraky I, el-Assmy AM, et al. Percutaneous treatment of large upper tract stones after urinary diversion. Urology. 68(3):500-4, 2006 Sep. |
Observational-Tx |
24 patients |
To present our experience in percutaneous management of large upper tract stones after urinary diversion. |
Renal punctures were guided with ultrasonography in 18 patients (75%) and fluoroscopy in 6 patients.One intraoperative complication (4.16%) and two postoperative complications (8.3%) occurred. All patients withureteral stones became stone free after one procedure. Auxiliary procedures were needed in 5 patients afterpercutaneous nephrolithotomy; 2 patients required a second session and 3 needed extracorporeal shock wavelithotripsy. The overall success rate was 87.5% (21 patients). One patient with treatment failure underwent opensurgery, and two with small residual fragments were followed up. Long-term follow-up data were available for 15patients. The stone recurrence rate was 33.3% (5 patients) after a median follow-up of 40 months (range 14 to132). Recurrent stones were treated with extracorporeal shock wave lithotripsy. |
3 |
| 14. El-Nahas AR, Shokeir AA. Endourological treatment of nonmalignant upper urinary tract complications after urinary diversion. [Review]. Urology. 76(6):1302-8, 2010 Dec. |
Review/Other-Tx |
N/A |
To review indications, techniques, results and complications of endourologic modalities and compare the outcomes with open surgical techniques. |
No results stated in abstract. |
4 |
| 15. Chalmers N, Jones K, Drinkwater K, Uberoi R, Tawn J. The UK nephrostomy audit. Can a voluntary registry produce robust performance data? Clin Radiol. 2008;63(8):888-894. |
Review/Other-Tx |
3262 patients |
Multicenter study to investigate the effectiveness of the Royal College of Radiologists Audit Sub-Committee's national prospective registry of PCN, which enables participants to audit their practice and compare performance with predetermined standards. |
A satisfactory level of performance was achieved with an overall technical success rate of 98% and a complication rate of 6.3%. Significant risk factors for complications included rigors, anaemia, and impaired renal function. Low frequency operators were shown to have a lower technical success rate and a higher complication rate than high frequency operators. |
4 |
| 16. Farrell TA, Hicks ME. A review of radiologically guided percutaneous nephrostomies in 303 patients. J Vasc Interv Radiol. 1997;8(5):769-774. |
Observational-Tx |
303 patients; 454 consecutive PCN |
Retrospective review to determine the morbidity and mortality associated with radiologically guided PCN and to identify possible contributory risk factors. |
Technical success was 99%. Overall complication rate was 6.5%, including hemorrhage requiring transfusion after 13 PCNs (2.8%). A baseline platelet count of <100,000/mm3 was a significant risk factor for hemorrhage requiring blood transfusion. The 30-day mortality rate was 3.1%; however, none of these deaths were procedure related. |
3 |
| 17. Lee WJ, Mond DJ, Patel M, Pillari GP. Emergency percutaneous nephrostomy: technical success based on level of operator experience. J Vasc Interv Radiol. 1994;5(2):327-330. |
Review/Other-Tx |
160 patients; 169 emergency PCN |
Prospective study to evaluate the impact of operator experience on emergency PCN. Three categories of operator experience were compared based on the number of PCN performed each year (level 1 is >20, level 2 is 10-20, or level 3 is <10). |
At threshold of 10 or more procedures per year, operator experience has little impact on immediate technical success. Level of experiences does impact fluoroscopy and procedure time, minor complications, and need for repeat procedures. |
4 |
| 18. Lee WJ, Patel U, Patel S, Pillari GP. Emergency percutaneous nephrostomy: results and complications. J Vasc Interv Radiol. 1994;5(1):135-139. |
Observational-Tx |
160 patients |
To evaluate the effectiveness and safety of PCN in an emergency setting. |
Technical success rate was 98%. Complication rate was 34% (6% major and 28% minor). Emergency PCN under fluoroscopic guidance is a simple, safe, and effective procedure and should be offered in all suitably equipped radiology departments. |
3 |
| 19. Montvilas P, Solvig J, Johansen TE. Single-centre review of radiologically guided percutaneous nephrostomy using "mixed" technique: success and complication rates. Eur J Radiol. 80(2):553-8, 2011 Nov. |
Review/Other-Tx |
353 patients |
A review of complication and success rates of the “mixed” technique in PCN using both the Seldinger and one-step techniques in dilated and non-dilated systems. |
All of the 500 nephrostomies were successful within 24hours (96.2% primary; 3.8% postponed). The success rate of primary nephrostomy in dilated and non-dilated systems was 98.2% and 82%, respectively. Major complications occurred in 0.45% and minor complications in 14.2%. |
4 |
| 20. Ramchandani P, Cardella JF, Grassi CJ, et al. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol. 2003;14(9 Pt 2):S277-281. |
Review/Other-Tx |
N/A |
Guidelines for PCN. |
Underwent rigorous SIR review process following National Guidelines Clearinghouse evidence based guidelines criteria. |
4 |
| 21. Gray RR, So CB, McLoughlin RF, Pugash RA, Saliken JC, Macklin NI. Outpatient percutaneous nephrostomy. Radiology. 1996;198(1):85-88. |
Observational-Tx |
48 patients; 60 PCN procedures |
Retrospective review of data to evaluate role of PCN as an outpatient procedure in a select group of patients. |
100% technical success. In appropriately selected patients, 88% of PCNs can be done without hospitalization. Outpatient PCN is feasible and safe and yields major cost savings. |
3 |
| 22. von der Recke P, Nielsen MB, Pedersen JF. Complications of ultrasound-guided nephrostomy. A 5-year experience. Acta Radiol. 1994;35(5):452-454. |
Review/Other-Tx |
159 patients; 285 US-guided nephrostomy procedures |
Retrospective evaluation of US-guided PCN complications. |
Technical success rate of 92%. 33 catheters dislodged within 10 days. Other complications in 6.7% of procedures. US-guided nephrostomy is a gentle procedure with few major complications, but the risk of the procedure should still be weighed against the expected benefit. |
4 |
| 23. Uppot RN.. Emergent nephrostomy tube placement for acute urinary obstruction. [Review] [28 refs]. Tech Vasc Interv Radiol. 12(2):154-61, 2009 Jun. |
Review/Other-Tx |
N/A |
To describe the step-by-step technique for image-guided percutaneous nephrostomy tube placement for the management of urinary obstruction. |
No results stated in abstract. |
4 |
| 24. Vehmas T, Kivisaari L, Mankinen P, et al. Results and complications of percutaneous nephrostomy. Ann Clin Res. 1988;20(6):423-427. |
Review/Other-Tx |
181 patients |
To evaluate the results and complications of PCN in a series of patients treated with PCN. |
Clinical improvement in 68% of patients. Major complications in 16% (5.5% major, 10.5% minor). Benefit of PCN was closely related to the existing renal recovery potential following the relief of obstruction. |
4 |
| 25. Shekarriz B, Shekarriz H, Upadhyay J, et al. Outcome of palliative urinary diversion in the treatment of advanced malignancies. Cancer. 1999;85(4):998-1003. |
Observational-Tx |
103 patients |
Retrospective study to evaluate survival and performance status after palliative diversion in patients with advanced malignancies. |
Primary endourologic procedures had high failure rates. 51% required secondary percutaneous procedures. Most patients had poor performance status after decompression. |
2 |
| 26. Barbaric ZL. Percutaneous nephrostomy for urinary tract obstruction. AJR. 1984;143(4):803-809. |
Review/Other-Tx |
N/A |
To review the role and technique of PCN. |
PCN is widely used in a variety of indications. PCN is a valuable procedure for providing temporary or permanent urinary diversion of an obstructed upper urinary tract. |
4 |
| 27. Soltes GD, Rainwater JR, Middlebrook MR, Cohen AM, Sickler GK, Sandler CM. Interventional uroradiology. World J Urol. 1998;16(1):52-61. |
Review/Other-Tx |
N/A |
To review issues pertaining to percutaneous urologic interventions. Emphasis is on urologic calculi, interventional therapy for neoplasms and trauma of the urinary tract, diagnosis and treatment of renovascular hypertension, and the management of complications following renal transplantation. |
Interventional uroradiologic techniques have impacted the care of the urologic patient by allowing nonoperative treatment of many disease processes. |
4 |
| 28. LeRoy AJ, May GR, Bender CE, et al. Percutaneous nephrostomy for stone removal. Radiology. 1984;151(3):607-612. |
Review/Other-Tx |
700 patients |
To evaluate the role of PCN in stone removal. Series of PCN placements were reviewed. |
Ease or complexity of stone removal depended upon precise PCN placement. PCN placement was successful in 716/720 kidneys (99.4%) referred for percutaneous renal or ureteral calculus removal. |
4 |
| 29. Goldberg SD, Gray RR, St Louis EL, Mahoney J, Jewett MA, Keresteci AG. Nonoperative management of complications of percutaneous renal nephrostomy. Can J Surg. 1989;32(3):192-195. |
Review/Other-Tx |
350 patients |
To evaluate nonoperative management of PCN complications. |
Complications requiring intervention in <2%. Open surgery in <0.5%. Complications managed conservatively included splenic puncture, false aneurysm, and laceration of the renal artery, arteriovenous fistula, hemorrhage requiring transfusion, pneumothorax-empyema, urinoma, septic shock and the hemolysis-hyponatremia-renal shutdown syndrome. |
4 |
| 30. Watson G. Problems with double-J stents and nephrostomy tubes. J Endourol. 1997;11(6):413-417. |
Review/Other-Tx |
N/A |
Review problems associated with double-J stents and nephrostomy tubes. |
Problems occur with both double J and percutaneous catheters. No stent is totally resistant to encrustation, and frequent changes are required. |
4 |
| 31. Alago W Jr, Sofocleous CT, Covey AM, et al. Placement of transileal conduit retrograde nephroureteral stents in patients with ureteral obstruction after cystectomy: technique and outcome. AJR Am J Roentgenol. 191(5):1536-9, 2008 Nov. |
Review/Other-Tx |
49 patients |
To describe the technique, complications, and long-term results of transileal conduit retrograde nephroureteral stents placed for ureteral obstruction after radical cystectomy. |
Forty-nine patients with ureteral obstruction underwent image-guided placement of 61 antegrade nephrostomy or nephroureterostomy catheters (37 unilateral, 12 bilateral) followed by attempted conversion to transileal conduit retrograde nephroureteral stents. Technical success was achieved in 56 of 61 renal units (91.8%). Clinical success, which was defined as resolution of creatinine elevation, urosepsis, and pain associated with hydronephrosis, occurred in 44 of 49 patients (89.8%) with a mean clinical follow-up of 22 months. Minor complications included tube dislodgement resulting in pericatheter leakage in two patients. No major complications occurred. Delayed complications including catheter dislodgement, recurrent urosepsis, and inability to exchange the retrograde nephroureteral stents were seen in four patients (8.2%) and were mostly due to catheter encrustation. |
4 |
| 32. Laven BA, O'Connor RC, Gerber GS, Steinberg GD. Long-term results of endoureterotomy and open surgical revision for the management of ureteroenteric strictures after urinary diversion. Journal of Urology. 170(4 Pt 1):1226-30, 2003 Oct. |
Observational-Tx |
22 patients |
To compare the safety and efficacy of endoureterotomy and open anastomotic repair in patients with ureteroenteric strictures after cystectomy and urinary diversion, and assessed the impact of prior endoureterotomy on secondary open anastomotic repair. |
At a median followup of 35 months (range 17 to 62) for endoureterotomy and 34 months (range 5 to 54) for open revision the success rate of endoureterotomy and open revision was 50% (8 of 16 renal units) and 80% (12 of 15), respectively. One of the 3 patients in whom open revision failed underwent prior pelvic external beam radiation and the other 2 underwent prior endoureterotomies. Overall interventions for right strictures were more successful 85% or 11 of 13 cases than those on the left side (50% or 9 of 18) (p = 0.037). Average operative time was longer and average estimated blood loss was higher in patients treated with open repair after failed endoureterotomy (p = 0.009 and 0.016, respectively). No complications developed in patients following endoureterotomy. |
2 |
| 33. Wang CJ, Hsu CS, Chen HW, Chang CH, Tsai PC. Percutaneous nephrostomy versus ureteroscopic management of sepsis associated with ureteral stone impaction: a randomized controlled trial. Urolithiasis. 44(5):415-9, 2016 Oct. |
Experimental-Tx |
107 patients |
To evaluate the efficacy, related complications, and convalescence of emergent retrograde ureteroscopic management, instead of percutaneous nephrostomy for decompression of the collecting system in cases of sepsis associated with ureteral stone obstruction. |
The length of hospital stay (days) was 10.25 ± 3.53 and 8.24 ± 2.77 in the percutaneous nephrostomy group and emergent retrograde ureteroscopic management group, respectively, with significant difference (Table 2). However, patients in the emergent retrograde ureteroscopic management group had a significantly higher rate of s body temperature (°C). Meanwhile, the analgesic consumptions are 31.51 ± 11.16 and 40.00 ± 14.54 in the percutaneous nephrostomy group and emergent retrograde ureteroscopic management group, respectively, with significant difference. |
1 |
| 34. Borofsky MS, Walter D, Shah O, Goldfarb DS, Mues AC, Makarov DV. Surgical decompression is associated with decreased mortality in patients with sepsis and ureteral calculi. J Urol. 189(3):946-51, 2013 Mar. |
Observational-Tx |
1,712 patients |
To determine the association between the receipt of surgical decompression and mortality in patients with combined sepsis and ureteral calculi. |
Of the patients 78% underwent surgical decompression. Mortality was higher in those not treated with surgical decompression (19.2% vs 8.82%, p <0.001). Lack of surgical decompression was independently associated with an increased OR of mortality even when adjusting for patient demographics, comorbidities and geographic region of treatment (OR 2.6, 95% CI 1.9–3.7). |
3 |
| 35. Joshi HB, Obadeyi OO, Rao PN. A comparative analysis of nephrostomy, JJ stent and urgent in situ extracorporeal shock wave lithotripsy for obstructing ureteric stones. BJU Int. 1999;84(3):264-269. |
Observational-Tx |
82 consecutive patients |
Retrospective analysis to determine the optimal method of treatment for ureteric stones causing complete obstruction, treated by insertion of a JJ stent or a nephrostomy tube, followed by extracorporeal shock wave lithotripsy or by urgent in situ extracorporeal shock wave lithotripsy if readily available. |
Urgent in situ extracorporeal shock wave lithotripsy (group 3) had a median (95% CI) success rate of 81% (54%-96%), compared with 70% (53%-83%) in group 2 and 54% (33%-73%) in group 1. If facilities are available, urgent in situ extracorporeal shock wave lithotripsy appears to be the choice of treatment for obstructing ureteric stones. If such facilities are not available, a JJ stent may offer better success than a PCN. |
2 |
| 36. Hyppolite JC, Daniels ID, Friedman EA. Obstructive uropathy in gynecologic malignancy. Detrimental effect of intraureteral stent placement and value of percutaneous nephrostomy. ASAIO J. 1995;41(3):M318-323. |
Observational-Tx |
41 patients |
Retrospectively review records of patients with obstructive uropathy and gynecologic malignancy to determine treatment, including indications for dialysis, and outcomes. |
Study shows that: intraureteral stent catheter placement predisposes to urosepsis and should be avoided; bilateral nephrostomy placement allows significant improvement in renal function, and is superior to either unilateral nephrostomy placement or combination nephrostomy-stent catheter placement; and dialysis is rarely applied to this population. |
2 |
| 37. Camunez F, Echenagusia A, Prieto ML, Salom P, Herranz F, Hernandez C. Percutaneous nephrostomy in pyonephrosis. Urol Radiol. 1989;11(2):77-81. |
Review/Other-Tx |
73 patients; 76 pyonephrotic kidneys |
Patients were drained by PCN tube and examined to evaluate role of PCN for pynephrosis. |
Clinical symptoms resolved 24-48 hours after drainage in 71/73 patients. After acute phase had remitted, interventional procedures were done in 39 cases (definitive therapy in 36). Elective surgery was the definitive therapy in 32 cases, including the 3 cases not resolved after interventional procedures. |
4 |
| 38. Ng CK, Yip SK, Sim LS, et al. Outcome of percutaneous nephrostomy for the management of pyonephrosis. Asian J Surg. 2002;25(3):215-219. |
Review/Other-Tx |
92 consecutive patients |
Retrospective study to evaluate the efficacy of PCN drainage for the interim management of pyonephrosis. |
30% of bladder urine cultures were positive for microorganisms; the addition of PCN cultures improved this yield to 58%. PCN cultures yield important bacteriological information. The procedure is associated with minimal morbidity, facilitates definitive treatment and provides therapeutic benefit. |
4 |
| 39. Ramsey S, Robertson A, Ablett MJ, Meddings RN, Hollins GW, Little B. Evidence-based drainage of infected hydronephrosis secondary to ureteric calculi. J Endourol. 24(2):185-9, 2010 Feb. |
Review/Other-Dx |
N/A |
To conduct a PubMed and Medline search on evidence based drainage of infected hydronephrosis secondary to ureteric calculi. |
Two randomized trials have compared retrograde stent insertion with PCN with one trial reporting specifically on patients with acute sepsis and obstruction. Neither trial showed one superior modality of decompression in effecting decompression and resolution of sepsis. A further literature search regarding the complications of PCN and stent insertion was carried out. An overall major complication rate from PCN insertion was found to be 4%, although the complication rates from stent insertion are less consistently reported. |
4 |
| 40. ElSheemy MS, Shouman AM, Shoukry AI, et al. Ureteric stents vs percutaneous nephrostomy for initial urinary drainage in children with obstructive anuria and acute renal failure due to ureteric calculi: a prospective, randomised study. BJU Int. 115(3):473-9, 2015 Mar. |
Observational-Tx |
90 children |
To compare percutaneous nephrostomy (PCN) tube vs JJ ureteric stenting as the initial urinary drainage method in children with obstructive calcular anuria (OCA) and post-renal acute renal failure (ARF) due to bilateral ureteric calculi, to identify the selection criteria for the initial urinary drainage method that will improve urinary drainage, decrease complications and facilitate the subsequent definitive clearance of stones, as this comparison is lacking in the literature. |
All presented patients completed the study with intention-to-treat analysis. There was no significant difference between the PCN-tube and JJ-stent groups for the operative and imaging times, period for return to a normal creatinine level and failure of insertion. There were significantly more complications in the PCN-tube group. The stone size (>2 cm) was the only factor affecting the rates of mucosal complications, operative time and failure of insertion in the JJ-stent group. The degree of hydronephrosis significantly affected the operative time for PCN-tube insertion. Grade 2 hydronephrosis was associated with all cases of insertion failure in the PCN-tube group. The total number of subsequent interventions needed to clear stones was significantly higher in the PCN-tube group, especially in patients with bilateral stones destined for chemolytic dissolution (alkalinisation) or extracorporeal shockwave lithotripsy (ESWL). |
1 |
| 41. Goldsmith ZG, Oredein-McCoy O, Gerber L, et al. Emergent ureteric stent vs percutaneous nephrostomy for obstructive urolithiasis with sepsis: patterns of use and outcomes from a 15-year experience. BJU Int. 112(2):E122-8, 2013 Jul. |
Observational-Tx |
130 patients |
To characterize the use of emergent JJ ureteric stent placement and percutaneous nephrostomy (PCN) for patients with obstructive urolithiasis with sepsis, and todetermine whether outcomes differ between the two treatment methods. |
• The overall rate of failed procedures was 2.3% (3/130), with one in-hospital death (0.8%). • Patients treated with PCN had larger stones (10 vs 7 mm, P = 0.031), and were more acutely ill (acute physiology, age, chronic health evaluation [APACHE] II scores of 15 vs 11, P = 0.036) than those treated with JJ stent placement.• Patients treated with PCN were more likely to require ICU admission (odds ratio: 3.23, 95% confidence interval [CI]: 1.24–8.41, P = 0.016), and demonstrated longer length of hospital stay (b: 0.47, 95% CI: 0.20–0.74, P = 0.001), even when adjusting for age, APACHE II score, and Charlson Comorbidity Index score. • After resolution of sepsis, patients treated with PCN were more likely to be treated definitively with a percutaneous approach, while patients treated with JJ stent placement were more likely to be treated ureteroscopically. |
2 |
| 42. Mokhmalji H, Braun PM, Martinez Portillo FJ, Siegsmund M, Alken P, Kohrmann KU. Percutaneous nephrostomy versus ureteral stents for diversion of hydronephrosis caused by stones: a prospective, randomized clinical trial. J Urol. 2001;165(4):1088-1092. |
Experimental-Tx |
40 patients |
Prospective, randomized clinical trial to compare PCN with ureteral stents for diversion of hydronephrosis caused by stones. |
PCN was successfully completed in 100% of patients and stents were successful in 80%, with a 20% conversion to PCN. Results indicate PCN is superior to ureteral stents for diversion of hydronephrosis caused by stones, especially in patients with a high temperature, as well as in males and juveniles. |
1 |
| 43. Lang EK, Price ET. Redefinitions of indications for percutaneous nephrostomy. Radiology. 1983;147(2):419-426. |
Review/Other-Tx |
218 patients |
To analyze patients treated by PCN and identify its indications and failures. |
PCN reduced the mortality from gram-negative septicemia from 40% to 8%. PCN was the single most important treatment modality in patients with septicemia and obstructive uropathy. |
4 |
| 44. Hsu CS, Wang CJ, Chang CH, Tsai PC, Chen HW, Su YC. Emergency percutaneous nephrostomy versus emergency percutaneous nephrolithotomy in patients with sepsis associated with large uretero-pelvic junction stone impaction: a randomized controlled trial. Int Braz J Urol. 43(3):481-488, 2017 May-Jun. |
Observational-Tx |
113 patients |
To evaluate the efficacy, related complications, and convalescence of emergency percutaneous nephrolithotomy compared to percutaneous nephrostomy for decompression of the collecting system in cases of sepsis associated with large uretero-pelvic junction stone impaction. |
The length of hospital stays (in days) was 10.09±3.43 for the emergency percutaneous nephrostomy group and 8.18±2.72 for the percutaneous nephrolithotomy group. This set of data noted a significant difference between groups. There was no difference between groups in regard to white blood cell count (in mm3), time to normalization of white blood cell count (in days), body temperature (in ºC), time to normalization of body temperature (in days), C-reactive proteins (in mg/dL), time taken for C-reactive proteins to decrease over 25% (in days), procalcitonin (in ng/mL), or complication rates. |
1 |
| 45. Chen L, Xu QQ, Li JX, Xiong LL, Wang XF, Huang XB. Systemic inflammatory response syndrome after percutaneous nephrolithotomy: an assessment of risk factors. Int J Urol. 15(12):1025-8, 2008 Dec. |
Observational-Tx |
209 patients |
To analyze the risk factors for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) and to quantitatively predict the probability of SIRS after PCNL. |
The incidence of SIRS after PCNL was 23.4%. The key risk factors for SIRS following PCNL were: the number of tracts, receipt of a blood transfusion, stone size, and presence of pyelocaliectasis. Other factors added no independent risk to the development of SIRS. The calculated values for sensitivity, specificity, overall percentage correct, positive predictive value and negative predictive value were 44.9%, 95.0%, 83.3%, 73.3%, and 84.9%, respectively. |
2 |
| 46. Biyani CS, Joyce AD. Urolithiasis in pregnancy. II: management. [Review] [26 refs]. BJU International. 89(8):819-23, 2002 May. |
Review/Other-Tx |
N/A |
To provide a comprehensive review of the management of stone disease in pregnancy and outline a treatment algorithm. |
No results stated in abstract. |
4 |
| 47. Mandal AK, Sharma SK, Goswami AK, Hemal AK, Indudhara R. The use of percutaneous diversion during pregnancy. Int J Gynaecol Obstet. 1990;32(1):67-70. |
Review/Other-Tx |
3 patients (2 patients with infected hydronephros and one with calculus anuria) |
To evaluate percutaneous diversion during pregnancy. |
Maintenance of percutaneous diversion allowed continuation of pregnancy to term and effectively preserved renal function. |
4 |
| 48. Peer A, Strauss S, Witz E, Manor H, Eidelman A. Use of percutaneous nephrostomy in hydronephrosis of pregnancy. Eur J Radiol. 1992;15(3):220-223. |
Review/Other-Tx |
4 pregnant women |
To evaluate the use of PCN in hydronephrosis of pregnancy. |
The procedure provided rapid relief from pain and pyosepsis, and allowed uneventful continuation of the pregnancy to full-term, with preservation of renal function. |
4 |
| 49. Trewhella M, Reid B, Gillespie A, Jones D. Percutaneous nephrostomy to relieve renal tract obstruction in pregnancy. Br J Radiol. 1991;64(761):471-472. |
Review/Other-Tx |
1 case |
Describe role of PCN in hydronephrosis decompression in pregnancy. |
PCN is successful in relieving clinical symptoms. |
4 |
| 50. vanSonnenberg E, Casola G, Talner LB, Wittich GR, Varney RR, D'Agostino HB. Symptomatic renal obstruction or urosepsis during pregnancy: treatment by sonographically guided percutaneous nephrostomy. AJR. 1992;158(1):91-94. |
Review/Other-Tx |
7 pregnant women (5 pyonephrosi, 2 obstructed transplants) |
To evaluate role of US guided PCN in pregnant women with hydronephrosis. |
Prompt clinical improvement in all patients. Sonographically guided PCN is effective and safe method for pregnant women with symptomatic obstructive hydronephrosis associated with either pyosepsis or azotemia. |
4 |
| 51. Kavoussi LR, Albala DM, Basler JW, Apte S, Clayman RV. Percutaneous management of urolithiasis during pregnancy. J Urol. 1992;148(3 Pt 2):1069-1071. |
Review/Other-Tx |
6 pregnant women |
To evaluate the role of PCN for treatment of urolithiasis during pregnancy. |
All 6 women had uncomplicated vaginal deliveries of healthy newborns and are currently asymptomatic with no evidence of obstruction. Percutaneous drainage of an acutely obstructed kidney in a pregnant woman is an effective temporizing alternative to ureteral stent placement until definitive treatment can be performed. |
4 |
| 52. Khoo L, Anson K, Patel U. Success and short-term complication rates of percutaneous nephrostomy during pregnancy. J Vasc Interv Radiol. 2004;15(12):1469-1473. |
Review/Other-Tx |
8 patients |
Retrospectively study the outcome of PCN creation during pregnancy. |
Regular catheter flushing is recommended and early ureteroscopic inspection and stone extraction with or without ureteral stent implantation is preferred to long-term nephrostomy. Regular flushing is advised if the nephrostomy catheter is left in situ until delivery. 1/8 patients (12.5%) in study developed significant postprocedural sepsis and 2/8 births were premature. The possibility of increased risk of septic complications and preterm birth after PCN during pregnancy requires further study. |
4 |
| 53. Ishioka J, Kageyama Y, Inoue M, Higashi Y, Kihara K. Prognostic model for predicting survival after palliative urinary diversion for ureteral obstruction: analysis of 140 cases. J Urol. 180(2):618-21; discussion 621, 2008 Aug. |
Observational-Tx |
140 patients |
To analyze the clinical data of 140 patients with end stage cancer with ureteral obstruction treated with percutaneous nephrostomy by multivariate analysis and define a risk stratification model for predicting the benefit of palliative urinary diversion. |
Median overall survival was 96 days (range 2 to 1,283). The 1, 6 and 12-month survival rates were 78%, 30% and 12%, respectively. On multivariate analysis the number of events related to malignant dissemination (3 or more), degree of hydronephrosis (grade 1 or 2) and serum albumin before nephrostomy (3 gm/dl or less) were significantly associated with a short survival time. The patients were divided into 3 risk groups of favorable—0 risk factors (34 patients), intermediate—1 risk factor (60) and poor—2 or 3 risk factors (41). There were significant differences in the survival profiles of the 3 risk groups (p <0.0001). The 6-month survival rates for the favorable, intermediate and poor risk groups were 69%, 24% and 2%, respectively. |
2 |
| 54. Song Y, Fei X, Song Y, Percutaneous nephrostomy versus indwelling ureteral stent in the management of gynecological malignancies. Int J Gynecol Cancer. 22(4):697-702, 2012 May. |
Observational-Tx |
75 patients |
To evaluate the efficacy of retrograde ureteral stenting and to identify the predictive factors for potential failure of this technique in women with advanced gynecologic malignancies. |
Multivariate analysis revealed that mean preprocedureal serum cystanin C greater than 2.5 mg/L and length of the ureteral obstruction greater than 3 cm were significant predictors of stent failure. Neither the causes nor location of obstruction predicted the need for percutaneous nephrostomy (PCN). No statistical significance was detected among the subgroups of patients with different degrees of hydronephrosis. Statistical significant differences were found between the 2 groups in procedural time, average cost, and mean interval of stent/catheter replacement. However, no statistically significant difference was found in the median survival time and overall stent-related or catheter-related complications between the 2 groups. |
2 |
| 55. Kraemer PC, Borre M. [Relief of upper urinary tract obstruction in patients with cancer of the prostate]. Ugeskr Laeger. 2009;171(11):873-876. |
Review/Other-Tx |
51 journals; 237 procedures |
Retrospectively review prostate cancer patients and summarize the use of different kinds of catheters. |
Malignant extrinsic ureteral obstruction in prostate cancer patients is frequent and both types of relief are safe and efficient. Nephrostomies should be preferred in patients who are in bad health or infected while double-J stents - especially antegrade - should be offered to healthier or stronger patients. |
4 |
| 56. Ku JH, Lee SW, Jeon HG, Kim HH, Oh SJ. Percutaneous nephrostomy versus indwelling ureteral stents in the management of extrinsic ureteral obstruction in advanced malignancies: are there differences? Urology. 2004;64(5):895-899. |
Observational-Tx |
148 patients; PCN (n=80) or IUS (n=68) |
Retrospective analysis to compare the complications and morbidities after placement of a PCN tube or an IUS in the management of malignant ureteral obstruction in patients with advanced malignancy. |
Accumulated incidence of fever and acute pyelonephritis was not different in the two groups. The accumulated incidence and the incidence of febrile episodes in the IUS group was 10.3% and 0.0004/100 person-days; the corresponding values for the PCN group were 15.0% and 0.2154/100 person-days. The incidence of acute pyelonephritis in the IUS and PCN groups was 0.0002/100 person-days and 0.0005/100 person-days, respectively. |
2 |
| 57. Uthappa MC, Cowan NC. Retrograde or antegrade double-pigtail stent placement for malignant ureteric obstruction?. Clin Radiol. 60(5):608-12, 2005 May. |
Observational-Tx |
50 ureters in 30 patients |
To determine the optimum approach for double-pigtail stent placement in malignant ureteric obstruction. |
Retrograde placement was attempted in 50 ureters in 30 patients {19 male, 11 female, average age 61.4 yr (range 29–90 yr)} over a 24-month period. The success rate for retrograde ureteric stent placement was 50% (n=25/50). Technical failures were due to failure to identify the ureteric orifice (n=22), failure to cross the stricture (n=1), failure to pass the stent (n=1) and failure to pass a 4 Fr catheter (n=1). Antegrade placement was attempted in 25 ureters with a success rate of 96% (n=24/25). Failure in the one case was due to inability to cross an upper third stricture secondary to pyeloureteritis cystica. |
3 |
| 58. Dudley BS, Gershenson DM, Kavanagh JJ, Copeland LJ, Carrasco CH, Rutledge FN. Percutaneous nephrostomy catheter use in gynecologic malignancy: M.D. Anderson Hospital experience. Gynecol Oncol. 1986;24(3):273-278. |
Review/Other-Tx |
30 patients |
A study on the follow-up of the clinical courses of 30 patients with 41 nephrostomy catheters. |
Common complications were hemorrhage (28%), infection (70%), and blockage of catheter (65%). No deaths occurred as a result of these complications. Renal function recovered in 14/20 patients (70%) who presented with elevated creatinine values. 26/28 patients with malignant obstruction were able to receive further therapy. The only long-term survivors presented with primary advanced cervical cancer. |
4 |
| 59. Allen DJ, Longhorn SE, Philp T, Smith RD, Choong S. Percutaneous urinary drainage and ureteric stenting in malignant disease. [Review]. Clin Oncol (R Coll Radiol). 22(9):733-9, 2010 Nov. |
Review/Other-Tx |
N/A |
An overview to describe the surgical principles and technical issues involved with the endoscopic and percutaneous options in malignant ureteric obstruction. |
Patients with malignant ureteric obstruction often have a poor life expectancy, even if relief of urinary obstruction is achieved. Careful discussion between the patient, their family and health care professionals involved in the case must be undertaken before any intervention. The goal of treatment in the palliative setting may be to offer symptom relief, avoid complications from renal insufficiency or allow further oncological systemic therapy. The obstruction can be relieved by placement of a PCN tube, a ureteric stent or, more rarely, due to the palliative nature of the patients, a more complex open surgical procedure. |
4 |
| 60. Jalbani MH, Deenari RA, Dholia KR, Oad AK, Arbani IA. Role of percutaneous nephrostomy (PCN) in malignant ureteral obstruction. JPMA J Pak Med Assoc. 60(4):280-3, 2010 Apr. |
Observational-Tx |
40 patients |
To assess whether PCN placement in patients having malignant ureteric obstruction can provide patient benefit or increase morbidity. |
Patients having early or urogenital malignancies benefited from the PCN placement while patients with advanced malignancies and nonurogenital malignancies showed poor response. The median survival in urogenital malignancies was about 350 days (range was 150-700 days), and in nonurogenital malignancies except lymphoma it was about 25 days. (Range was 7-80 days). Loss of nephrostomy catheter was the most frequent complication observed in this series. |
2 |
| 61. Lapitan MC, Buckley BS. Impact of palliative urinary diversion by percutaneous nephrostomy drainage and ureteral stenting among patients with advanced cervical cancer and obstructive uropathy: a prospective cohort. J Obstet Gynaecol Res. 37(8):1061-70, 2011 Aug. |
Observational-Tx |
198 patients |
To evaluate the benefits offered by urinary diversion by comparing survival among those requiring and undergoing diversion with those requiring but not undergoing and those not requiring the procedure. |
Complete data were available for 198 patients, of whom 93 underwent diversion, 56 required diversion but elected not to receive it, and 49 did not require it. Although survival at 12 months among those who underwent diversion was no greater than among those who required but elected not to receive the procedure, diversion was associated with significantly improved chance of survival in the shorter term. There was no significant difference in the QOL between the groups throughout the study. |
1 |
| 62. Plesinac-Karapandzic V, Masulovic D, Markovic B, et al. Percutaneous nephrostomy in the management of advanced and terminal-stage gynecologic malignancies: outcome and complications. Eur J Gynaecol Oncol. 31(6):645-50, 2010. |
Observational-Tx |
117 patients |
To evaluate the outcome and complications after PCN insertion in advanced and terminal-stage gynecological malignancies with ureteral obstruction. |
The median age was 51 years (range 28-85). Bilateral nephrostomy was performed in 36.7% and unilateral in 63.3%. Renal function normalization occurred in 24.8%. 2-year OS was 16.8%. Higher OS occurred in patients without initial azotemia versus those with azotemia (26.8% vs 13.9%). Median survival time for all the patients was 7 months, 8 in primary cases versus 6 in recurrent ones, and 8 months in patients after initial therapy. Complications appeared in 53.85%. Most frequent were the loss of the nephrostomy catheter in 37.61% and urinary tract infections in 19.6%. |
2 |
| 63. Aravantinos E, Anagnostou T, Karatzas AD, Papakonstantinou W, Samarinas M, Melekos MD. Percutaneous nephrostomy in patients with tumors of advanced stage: treatment dilemmas and impact on clinical course and quality of life. J Endourol. 2007;21(11):1297-1302. |
Observational-Tx |
270 patients |
To evaluate the outcome, in respect to safety, survival, and QOL, after performance of PCN in patients with obstructive nephropathy caused by various types of advanced malignancy. |
Although PCN has shown good safety characteristics and beneficial impact on renal function, only patients with specific cancers most likely to respond to ongoing palliative therapy or with cancers that progress slowly by nature may statistically benefit from the procedure. This questions the universal application of this procedure for all types and stages of advanced malignancy. |
2 |
| 64. Chan S, Robinson AC, Johnson RJ. Percutaneous nephrostomy: its value in obstructive uropathy complicating carcinoma of cervix uterus. Clin Oncol (R Coll Radiol). 1990;2(3):156-158. |
Review/Other-Tx |
25 patients |
To evaluate the role of PCN in obstructive uropathy secondary to cervical cancer. |
Best results in patients with no previous cancer treatment and in patients with treatment-related complications. |
4 |
| 65. Feuer GA, Fruchter R, Seruri E, Maiman M, Remy JC, Boyce JG. Selection for percutaneous nephrostomy in gynecologic cancer patients. Gynecol Oncol. 1991;42(1):60-63. |
Observational-Tx |
22 patients |
To determine if evaluation prior to PCN could accurately predict patients who would benefit from intervention. |
Patients without contraindications to PCN survive longer and have better QOL than terminal patients. |
1 |
| 66. Chapman ME, Reid JH. Use of percutaneous nephrostomy in malignant ureteric obstruction. Br J Radiol. 1991;64(760):318-320. |
Review/Other-Tx |
17 patients |
To evaluate the role of PCN in malignant ureteric obstruction. |
Renal function improved in 88%. Mean survival was 18 weeks. Minor complications in 58%. Bilateral tubes confer no benefit over unilateral ones. |
4 |
| 67. Watkinson AF, A'Hern RP, Jones A, King DM, Moskovic EC. The role of percutaneous nephrostomy in malignant urinary tract obstruction. Clin Radiol. 1993;47(1):32-35. |
Observational-Tx |
50 consecutive patients |
Retrospective study to establish a protocol for selection of patients with abdominopelvic malignancy most likely to benefit from nephrostomy for renal obstruction. |
Four groups: Group I, renal obstruction caused by a nonmalignant complication as a result of previous surgery or radiotherapy (n=8); Group II, renal obstruction due to untreated primary malignancy (n=16); Group III, renal obstruction from relapsed disease with a viable treatment option (n=8); and Group IV, relapsed disease with no conventional treatment option (n=18). There was significant benefit from PCN in Groups I–III. The overall median survival time of Group IV patients was extremely poor: 38 days (range 6–143 days) with no long-term survivors. No worthwhile benefit is obtained if nephrostomy is used as a palliative measure in the absence of definitive treatment. |
2 |
| 68. Misra S, Coker C, Richenberg J. Percutaneous nephrostomy for ureteric obstruction due to advanced pelvic malignancy: have we got the balance right?. Int Urol Nephrol. 45(3):627-32, 2013 Jun. |
Observational-Tx |
22 patients |
To assess survival and complication rates post-percutaneous nephrostomy (PCN) in patients with ureteric obstruction due to advanced pelvic malignancy. |
Thirty-six nephrostomies were performed on 22 patients with prostate cancer being the commonest primary (55 %). Renal failure was the commonest mode of presentation (56 %). Eight patients (36 %) presented without a prior diagnosis of cancer. All PCNs except one were initially technically successful, and 56 % of renal units were able to be antegradely stented and rendered free of nephrostomy. Median survival post-nephrostomy was 78 days (range 4–1,137), with the subset of bladder cancer patients having the poorest survival. Dislodgement of the nephrostomy tube was the most common troublesome complication which led to the greatest morbidity, sometimes requiring repeat nephrostomy insertion. Patients stayed for a median of 23 (range 3–89) days in hospital, which amounted to 29 % of their remaining lifetime spent in hospital. |
2 |
| 69. Bahu R, Chaftari AM, Hachem RY, et al. Nephrostomy tube related pyelonephritis in patients with cancer: epidemiology, infection rate and risk factors. J Urol. 189(1):130-5, 2013 Jan. |
Observational-Tx |
200 patients |
To determine rates of nephrostomy tube related pyelonephritis and predisposing risk factors in patients with cancer. |
Of the 200 patients analyzed 38 (19%) had pyelonephritis and 15 (7.5%) had asymptomatic bacteriuria. Of the nephrostomy tube related infections 34 cases (89%) were with the primary nephrostomy tube. Subsequently 4 of the patients who underwent nephrostomy tube exchange had an episode of pyelonephritis. Pyelonephritis developed within the first month in 19 (10%) patients. Prior urinary tract infection and neutropenia were found to be significant risk factors for pyelonephritis (p = 0.047 and 0.03, respectively). |
2 |
| 70. Lienert A, Ing A, Mark S. Prognostic factors in malignant ureteric obstruction. BJU Int. 104(7):938-41, 2009 Oct. |
Observational-Tx |
49 patients |
To validate a model to stratify patients with obstructive nephropathy due to malignant ureteric obstruction associated with a poor prognosis, into different prognostic groups, as a recent report identified low serum albumin, degree of hydronephrosis and number of events related to metastatic disease as prognostic indicators before palliative decompression. |
Tumors were of urological origin in 66% of patients. Patients with prostate cancer had nephrostomy tubes indwelling for a mean of 279 days vs 190 days (P=0.07) for patients with tumors not of prostatic origin. A serum albumin level of >30 g/L (P=0.001), serum sodium <135 mmol/L (P=0.019) and three or more events related to dissemination of cancer (P=0.04) were factors associated with a significantly shorter mean survival. Complications related to the nephrostomy tube were experienced by 39% of patients. The model proved useful in stratifying these patients into different risk groups (P=0.002). |
2 |
| 71. Adamo R, Saad WE, Brown DB. Management of nephrostomy drains and ureteral stents. [Review] [15 refs]. Tech Vasc Interv Radiol. 12(3):193-204, 2009 Sep. |
Review/Other-Tx |
N/A |
To detail techniques and management of percutaneously placed ureteral and nephroureteral catheters. |
No results stated in abstract. |
4 |
| 72. Vahlensieck W, Friess D, Fabry W, Waidelich R, Bschleipfer T. Long-term results after acute therapy of obstructive pyelonephritis. Urol Int. 94(4):436-41, 2015. |
Review/Other-Tx |
57 patients |
To evaluate therapeutic results till 5 years after therapy of obstructive pyelonephritis (OPN) emphasizing regular follow-up. |
In the group of 57 patients (average age 56 years), about two third were women. Urolithiasis (65%) and tumors (21%) were the main causes of obstruction; fever (91%) and loin pain (86%) the main symptoms. Three fourth of the patients showed renal insufficiency and nearly 50% anemia. E. coli and Proteus spp. were the dominating organisms. Sonography detected obstruction in 93% cases. In one third of cases, CT scan was added; 81% percutaneous nephrostomy and 19% ureteral stenting were the initial methods of urinary drainage. During therapy, 23% nephrectomies (19% complete, 4% partial) were performed. Long-term follow-up showed 11% recurrent OPN and 33% recurrent UTI. |
4 |
| 73. Dassouli B, Benlemlih A, Joual A, et al. [Percutaneous nephrostomy in emergencies. Report of 42 cases]. Ann Urol (Paris). 2001;35(6):305-308. |
Review/Other-Tx |
42 cases |
Retrospective study to demonstrate the interest and the contribution of the PCN in obstructive anuria and in pyonephrosis. |
Improvement of the renal function was noted in 100% of obstructive with anuria and apyrexy in every case of pyonephrosis. No major complication arose during the realization of the nephrostomy. The long-term prognostic depends on the etiology. |
4 |
| 74. Angulo JC, Gaspar MJ, Rodriguez N, Garcia-Tello A, Torres G, Nunez C. The value of C-reactive protein determination in patients with renal colic to decide urgent urinary diversion. Urology. 76(2):301-6, 2010 Aug. |
Observational-Dx |
110 consecutive patients |
To analyze whether C-reactive protein predicts the need for urgent urinary diversion in patients with renal colic and urolithiasis. |
Mean C-reactive protein value was 47.6 mg/L (CI, 31.4-63.8), 139.6 mg/L (CI, 13-183.1) in 29 patients treated with diversion and 14.67 mg/L (CI, 6.7-22.5) in the control group (P<.001). Age, sex, rate of patients with hypertension, history of cardiovascular disease, leukocyte total count, and serum creatinine differed between groups (P<.05). Regression analysis revealed C-reactive protein (P<.0001) and age (P=.0001) were predictive of urinary diversion. Receiver operating characteristic analysis revealed 68.4% area under the curve for creatinine, 68.8% for leukocytosis, and 86.8% for C-reactive protein. A cut-off point for C-reactive protein of 28 mg/L achieved optimum sensitivity (75.8%) and specificity (88.9%) for determining the decision for drainage. |
3 |
| 75. Nicolescu D, Boja R, Osanu V, et al. Emergency percutaneous nephrostomy in the septic kidney. Acta Urol Belg. 1992;60(1):27-32. |
Review/Other-Tx |
64 patients |
To evaluate the role of emergency PCN in patients presenting with toxico-septic shock. |
Survival in 53/64 patients. There were 11 deaths. Under the protection of PCN, the stone generating obstructive uropathy was removed subsequently, after the improvement of biological constants and general state of the patient. |
4 |
| 76. Watson RA, Esposito M, Richter F, Irwin RJ, Jr., Lang EK. Percutaneous nephrostomy as adjunct management in advanced upper urinary tract infection. Urology. 1999;54(2):234-239. |
Review/Other-Tx |
315 patients |
Retrospective review of PCN, performed for pyonephrosis to determine whether this intervention has major clinical advantages. |
PCN is potentially lifesaving in pyonephrosis. In particular, this review focuses attention on the clinically important insight that urine cultures from PCN drainage often identify pathogens that differ from those detected in concurrent bladder cultures. |
4 |
| 77. Pasiechnikov S, Buchok O, Sheremeta R, Banyra O. Empirical treatment in patients with acute obstructive pyelonephritis. Infect Disord Drug Targets. 15(3):163-70, 2015. |
Observational-Tx |
241 patients |
To compare efficacy of fluoroquinolone ciprofloxacin vs 3rd generation cephalosporin ceftazidime in empirical antibacterial treatment of patients with acute obstructive pyelonephritis and to analyze the impact of urinary drainage option on cure rates. |
Our results revealed that cure rates in patients treated by ceftazidime were higher than those who were treated by ciprofloxacin. At late follow-up, the clinical cure rate in PNS group treated by ceftazidime was 95.2% vs 83.6% in ciprofloxacin arm, while the microbiological cure rates were 92.9% vs 80.0% correspondingly (p<0.05). At late follow-up, the clinical cure rate in US group treated by ceftazidime was 86.4% vs 74.1% in ciprofloxacin arm while the microbiological cure rates were 82.4% vs 69.4% correspondingly (p<0.05). |
1 |
| 78. Bartone FF, Hurwitz RS, Rojas EL, Steinberg E, Franceschini R. The role of percutaneous nephrostomy in the management of obstructing candidiasis of the urinary tract in infants. J Urol. 1988;140(2):338-341. |
Review/Other-Tx |
5 neonates |
To evaluate the role of PCN in obstructing candidacies in infants. |
Technical success in 3/5 cases. PCN with antegrade amphotericin B irrigation, coupled with systemic antifungal therapy, is the mainstay of treatment. |
4 |
| 79. Mertens S, Zeegers AG, Wertheimer PA, Hendriksz TR, van Bommel EF. Efficacy and complications of urinary drainage procedures in idiopathic retroperitoneal fibrosis complicated by extrinsic ureteral obstruction. Int J Urol. 21(3):283-8, 2014 Mar. |
Observational-Tx |
30 patients |
To investigate the efficacy and complications of urinary drainage procedures in patients with idiopathic retroperitoneal fibrosis complicated by ureteral obstruction. |
In 12 of 44 (27%) cases, percutaneous nephrostomy was carried out at the first step. Attempted ureteral stenting at the first step was successful in 25 of 32 (79%)cases, of which 20 (80%) cases could be managed successfully by ureteral stenting alone throughout the study period. Successful prolonged urinary drainage with percutaneous nephrostomy alone was accomplished in 10 cases, three at the first step and seven at the second step after failed intraureteral stent insertion or after unsuccessful maintenance of urinary drainage with an intraureteral stent. A total of 21 urinary tract infection episodes occurred in 11 patients. The incidence and accumulated incidence of acute pyelonephritis was 0.062 episodes/100 person-days and 30%, respectively. The incidence and accumulated incidence of urosepsis was 0.015 episodes/100 person-days and 6.6%, respectively. The overall number of complications did not differ between external and internal urinary drainage procedures (percutaneous nephrostomy, 21% vs intraureteral stent, 17.9%; P = 0.79). |
2 |
| 80. Greenstein A, Kaver I, Chen J, Matzkin H. Does preoperative nephrostomy increase the incidence of wound infection after nephrectomy? Urology. 1999;53(1):50-52. |
Observational-Tx |
31 patients |
Retrospective study to determine whether patients with nephrostomy who had simple nephrectomy had more postoperative complications than patients who underwent the same procedure but without nephrostomy. |
7 (31.8%) of the 22 patients without nephrostomy (group 1) had wound infection compared with 7 (77.7%) of the 9 patients with nephrostomy (group 2) (P<0.05). All 9 group 2 patients had infected urine compared with 11 of the 22 in group 1 (P<0.05). |
2 |
| 81. Lask D, Abarbanel J, Luttwak Z, Manes A, Mukamel E. Changing trends in the management of iatrogenic ureteral injuries. J Urol. 1995;154(5):1693-1695. |
Review/Other-Tx |
44 (24 treated by immediate reconstructive surgery and 20 treated by PCN tube) |
Comparative study to evaluate nephrostomy vs. immediate reconstruction in setting of ureteral injury at surgery. |
Primary management with nephrostomy decreases need for reoperation and usually enables spontaneous recovery. |
4 |
| 82. Bodner L, Nosher JL, Siegel R, Russer T, Cummings K, Kraus S. The role of interventional radiology in the management of intra- and extra-peritoneal leakage in patients who have undergone continent urinary diversion. Cardiovasc Intervent Radiol. 1997;20(4):274-279. |
Review/Other-Tx |
37 consecutive patients |
To evaluate role of interventional radiology decompression in patients with post-op leaks from continent urinary diversions. |
7 patients required radiologic intervention. Intervention in the form of drainage catheter manipulation (n=4), PCN (n=4), or ureteral stent placement (n=2) resulted in cessation of leakage without surgical intervention in all seven patients. Leaks can frequently be controlled with PCN and/or percutaneous fluid drainage. |
4 |
| 83. Fontaine AB, Nijjar A, Rangaraj R. Update on the use of percutaneous nephrostomy/balloon dilation for the treatment of renal transplant leak/obstruction. J Vasc Interv Radiol. 1997;8(4):649-653. |
Observational-Tx |
61 patients |
Retrospective evaluation of the efficacy of PCN and nephroureteral stent placement for treatment of post-transplant ureteral leak, and PCN and balloon dilation for treatment of post-transplant ureteral obstruction. |
PCN is very effective in improving renal function in patients with early obstruction. It is moderately successful in treating ureteral leak. Ureteral balloon dilatation is moderately effective for treatment of obstruction in the early (<3 months) postoperative period. However, balloon dilation is minimally successful in curing ureteric obstruction occurring more than 3 months after transplantation. |
2 |
| 84. Goldstein I, Cho SI, Olsson CA. Nephrostomy drainage for renal transplant complications. J Urol. 1981;126(2):159-163. |
Review/Other-Tx |
317 (204 cases of ureteral extravasation or fistula and 113 cases of ureteral obstruction) |
Review the role of PCN as part of treatment for transplant kidney ureteral complications. |
Surgical repair of ureteral injuries failed in 204 cases (30.9%). 86.7% (85 cases) occurred in patients without nephrostomy compared to 13.3% (13 cases) in patients with nephrostomy. Use of nephrostomy in transplant patients with ureteral extravasation, fistulas or ureteral obstruction is encouraged strongly to optimize patient and renal unit survival. |
4 |
| 85. Ustunsoz B, Ugurel S, Duru NK, Ozgok Y, Ustunsoz A. Percutaneous management of ureteral injuries that are diagnosed late after cesarean section. Korean J Radiol. 9(4):348-53, 2008 Jul-Aug. |
Review/Other-Tx |
22 patients |
To present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). |
Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). |
4 |
| 86. al-Ali M, Haddad LF. The late treatment of 63 overlooked or complicated ureteral missile injuries: the promise of nephrostomy and role of autotransplantation. J Urol. 1996;156(6):1918-1921. |
Review/Other-Tx |
63 consecutive patients |
Review the treatment of patients with ureteral injuries that were missed during or after complicated primary surgery. |
Leakage, internal or external, ceased in all 46 patients who underwent nephrostomy, of whom 20 (44%) had a patent ureter after 3 to 8 weeks and no further reconstruction was needed. When treating fistulas, urinomas, urinary ascites and obstruction due to a missed ureteral injury or a complication of the primary operation, the best results are achieved with initial nephrostomy followed by reconstruction when needed. Nephrostomy was a definitive treatment in 44% of cases with leakage and it protected any required reconstruction. |
4 |
| 87. American College of Radiology. ACR–SPR Practice Parameter for the Safe and Optimal Performance of Fetal Magnetic Resonance Imaging (MRI). Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/mr-fetal.pdf |
Review/Other-Dx |
N/A |
To promote safe and optimal performance of fetal magnetic resonance imaging (MRI). |
No abstract available. |
4 |
| 88. American College of Radiology. ACR-SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Patients with Ionizing Radiation. Available at: http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Pregnant_Patients.pdf. |
Review/Other-Dx |
N/A |
To assist practitioners in providing appropriate radiologic care for pregnant or potentially pregnant adolescents and women by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 89. American College of Radiology. ACR-ACOG-AIUM-SMFM-SRU Practice Parameter for the Performance of Standard Diagnostic Obstetrical Ultrasound. Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/us-ob.pdf |
Review/Other-Dx |
N/A |
To promote the safe and effective use of diagnostic and therapeutic radiology by describing the key elements of standard ultrasound examinations in the first, second, and third trimesters of pregnancy. |
No abstract available. |
4 |
| 90. American College of Radiology. Manual on Contrast Media. Available at: https://www.acr.org/Clinical-Resources/Contrast-Manual. |
Review/Other-Dx |
N/A |
To assist radiologists in recognizing and managing risks associated with the use of contrast media. |
No abstract available. |
4 |
| 91. Expert Panel on MR Safety, Kanal E, Barkovich AJ, et al. ACR guidance document on MR safe practices: 2013. J Magn Reson Imaging. 37(3):501-30, 2013 Mar. |
Review/Other-Dx |
N/A |
To help guide MR practitioners regarding MR safety issues and provide a basis for them to develop and implement their own MR policies and practices. |
No abstract available. |
4 |
