The Seldinger approach to percutaneous nephrostomy and ureteral stent placement.

The Seldinger approach to percutaneous nephrostomy and ureteral stent placement involves needle-puncture, guide wire introduction, tract dilation and catheter placement as in angiography. We have used this approach on 101 obstructed renal units without significant complication. Techniques are described in detail with special attention given to those for negotiating tortuous ureters. A guide wire through the kidney to the bladder can be used to place an indwelling stent either from above or below in order to free the patient completely from external appliances. These techniques afford exciting new alternatives in the management of common urological problems. Most of all, they offer nonoperative palliation to terminal cancer patients and suitable alternatives to patients too ill to undergo surgery.