Percutaneous nephrostomy in complicated urinary tract infections

Purpose:

The
study aimed to determine the various indications for PCN primarily in patients
with a urinary tract infection, and to determine the various complications
arising in these patients due to the procedure.

Materials
and methods

A
retrospective study of 5-years data based on registers of the Department of
Urology was performed. Among 716 patients, 226 inpatient data were obtained,
curated, and analyzed. Indications for PCN, the periprocedural complications,
the PCN's duration, details of antibiotics, risk factors for UTI, development
of acute kidney injury, and renal replacement therapy were recorded.

Results

Patients
were mostly female (53.1%, n=120/226). Malignancy (n=109, carcinoma
cervix=68/109) and nephrolithiasis (n=70) contributed to 79.2%. Infections such
as pyelonephritis, renal abscess, perinephric abscess, and genitourinary
tuberculosis were identified in 47. Infectious diseases were significantly
associated with younger age, female gender, diabetes, and prior pyelonephritis.
PCN was placed a median of two days after admission, and bilateral PCN was
placed in 36 (15.2%) patients. Hydroureteronephrosis (probably infected) was an
indication for PCN in 164/226 patients. In 33 patients with an infectious
disease, PCN was performed for an obstructed urinary system. One major and two
minor complications gave a rate of 0.06% for patients with infections, which
was less than the accepted threshold of 4%.

Conclusion

We
intended to study the utility and problems with placing a percutaneous
nephrostomy (PCN) catheter in patients with complicated urinary infections. We
conclude that PCN is a safe and effective procedure in urinary tract infections
with obstructed drainage.