Urologist directed percutaneous nephrostomy tube placement.

A retrospective analysis of 100 consecutive ultrasonically guided percutaneous nephrostomy tubes placed under the guidance of urologists was done. Complications related to tube insertion included sepsis in 3% of the cases, renal pelvic perforations in 2% and hemorrhage in 1%. There were no deaths and no need for open surgical intervention to manage these complications. An additional 21% of the tubes malfunctioned more than 24 hours after insertion, including dislodgement in 11%, occlusion in 6%, hemorrhage in 1%, peritubular leakage in 1%, puncture site infection in 1% and severe incrustation in 1%. These delayed complications were independent of tube type. Nephrostomy tubes may be placed safely by urologists. Urologists usually direct the need for percutaneous nephrostomy tube placement and use these ports for endourological manipulations and, therefore, they should have a greater role in catheter insertion.