Percutaneous nephrostomy in Ureteropelvic junction obstruction with poorly functioning kidney: Is it still pertinent in adults?

To determine the pertinence of percutaneous nephrostomy drainage in adult patients of primary ureteropelvic junction obstruction with poorly functioning kidneys (10% and had daily percutaneous nephrostomy output >400 mL, underwent pyeloplasty and the rest underwent nephrectomy. Seventy-two patients were studied, out of which 5 were in group I, 20 in groups II and III each, and27 in group IV. The mean age of presentation was 34.4 ± 14 years. The split renal function improvement of>10% was seen in 55 patients (76.4%) after percutaneous nephrostomy drainage (P < .05). Pyeloplasty wasdone in 40 patients (55.6%) and nephrectomy was done in 32 patients (44.4%). In conclusion, we recommend the use of a Tc-99m ethylenedicysteine scan for estimation of split renal function during the initial presentation in every patient followed by reconstructive surgery if split renal function is above 15% and nephrectomy if it is below 5%. The trial of percutaneous nephrostomy is pertinent if split renal function is between 6% and 15%.