Percutaneous Nephrostomy for urinary diversion in Obstructive Uropathy An appraisal

Dr. Hebbulse Shivalingaiah Prakash; Dr Suyash Bajoria

Volume : V, Issue : XII, December - 2016

Percutaneous Nephrostomy for urinary diversion in Obstructive Uropathy An appraisal

Dr. Hebbulse Shivalingaiah Prakash, Dr Suyash Bajoria

Abstract :

BACKGROUND– Obstructive uropathy (OU) is a frequent complication to many benign and malignant conditions. The urinary obstruction must be relieved immediately to avoid deterioration of kidney function. Percutaneous Nephrostomy (PCN) is a known method for relief from symptomatic or asymptomatic OU. However the benefits and morbidity associated with the procedure have long been debated without a proper consensus. MATERIALS AND METHODS– The forty patients (n=40) presenting with urinary obstructive features due to various causes constituted our study group. The patients were evaluated before and after PCN insertion with respect to the clinical and renal parameters. They were worked up on the basis of the Hospital Anxiety and Depression Score (HADS) Inventory and other questions pertaining to the intervention, in the six (6) weeks (wks) following PCN insertion. RESULTS– The general condition and laboratory parameters improved drastically after PCN insertion citing a favourable stance. The median HADS score and the responses to direct procedure related questions, all denoted a positive incline in favour of PCN. Patients having obstruction due to calculus disease were surgically managed for their underlying cause soon after stabilisation of the renal parameters and control of infection. CONCLUSION– PCN insertion has a positive impact on the quality of life in patients with OU whether due to benign or malignant causes, such that the patients with renal calculi can be surgically cured at a very short interval while patients with malignant obstruction can get rid of the sheer misery during the terminal stages of their lives.