Ultrasound Guided Direct Percutaneous Nephrostomy (PCN) Tube Placement: Stepwise Report of a New Technique with Its Safety and Efficacy Evaluation

Aims: Ultrasound guided Percutaneous Nephrostomy (PCN) tube placement: evaluation, safety and efficacy review. Settings and Design: This was a quasi-experimental study conducted at Department of Urology, Regional Institute of Medical Sciences, Imphal. Materials and Methods: The total number of 176 patients with grade I-IV hydronephrosis requiring PCN tube placement were included in the study. Scientific, operational and accessory steps of the technique and its related safety and efficacy pre-procedural, intra-procedural and post-procedural parameters were carefully and meticulously recorded. Statistical Analysis: Statistical analyses was performed using the Statistical Package for the Social Sciences (SPSS 16.0) for Windows. Results: The average length of the procedure was 9.07±2.79 (6-15) minutes. Severe procedure related pain (VAS score 8-10) was observed only in 18 patients (10.23%). Nephrostomy tube placement was successful in 96.60% of cases and only 9.66% required more than a single attempt of puncture. In this study, impacted ureteric calculus was found to be most common indication of PCN tube placement. Conclusions: Ultrasound guided direct PCN tube placement is a reliable, easy and cost effective technique. This procedure is particularly suitable for developing countries like India, where the majority of the patients belongs to the low socio-economical status and health care system lacks adequate infrastructural facility at most places.