PERCUTANEOUS NEPHROSTOMY FOR THE RELIEF OF UPPER URINARY TRACT OBSTRUCTION: AN EXPERIENCE WITH 200 CASES

Objective: To assess the role of Percutaneous Nephrostomy in upper obstructive uropathy. Material and Methods: This was a descriptive study, conducted at Department of Urology, Lady Reading Hospital and Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar from January 2006 to December 2008 on 200 patients of upper obstructive uropathy undergoing Percutaneous Nephrostomy. Fluoroscopy and Ultrasonography were used as guiding tools for accurate puncture of the renal tract. The patients were kept in the ward and their renal function tests were checked daily. All the data was collected on a structured proforma and analysis was done on SPSSv 10. Results: A total of 200 Percutaneous Nephrostomy were attempted in 200 patients. The mean age of the sample was 41.6+ 12.68 years. Male to female ratio was 2.3:1.The causes included Stone disease in 104 (52%), Pyonephrosis in 52 (26%), Malignancy in 20 (10%), Renal tract tuberculosis in 12 (6%), Obstetrical trauma in 8 (4%) and Ureteric Injury due to Fire Arm in 4 (2%) patients. It was successful in 192 patients, while there was a failure in 8 cases (4%). Considerable relief in terms of symptoms and renal biochemistry was observed with in a week:. The mean blood urea level of265 mg/dl before PCN dropped to 37 mg/dl and mean serum creatinine of 10.5 mg/dl dropped to 1.2 mg/dl respectively in all patients except 12 who were declared to have End Stage Renal Disease (ESRD). Conclusion: Percutaneous Nephrostomy improves the patientʹs condition both in terms of urinary output and renal parameters.