eMedicine Specialties > Urology > Surgery

Nephrostomy: Workup

Author: Stefan H Hautmann, MD, PhD, Assistant Professor, Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel Campus, Germany
Coauthor(s): Raymond J Leveillee, MD, FRCS(Glasg), Professor of Clinical Urology, Radiology and Biomedical Engineering, Department of Urology, University of Miami Miller School of Medicine; Chief, Division of Endourology/Laparoscopy and Minimally Invasive Surgery, Department of Urology, Jackson Memorial Hospital
Contributor Information and Disclosures

Updated: Nov 7, 2008

Workup

Laboratory Studies

  • Bleeding time, as indicated
  • Prothrombin time
  • Platelet count
  • Activated partial thromboplastin time (aPTT)
  • CBC count
  • Urine culture
  • Electrolyte assessment
  • Creatinine assessment

Imaging Studies

  • Any of the following studies can be used to assess patient anatomy:
    • Intravenous pyelography (IVP)
    • Abdominal CT scanning (see Images 4-5)
    • Renal ultrasonography

More on Nephrostomy

Overview: Nephrostomy
Workup: Nephrostomy
Treatment: Nephrostomy
Follow-up: Nephrostomy
Multimedia: Nephrostomy
References

References

  1. Goodwin WE, Casey WC, Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc. Mar 12 1955;157(11):891-4. [Medline].

  2. Fernström I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976;10(3):257-9. [Medline].

  3. Alken P, Hutschenreiter G, Gunther R, et al. Percutaneous stone manipulation. J Urol. Apr 1981;125(4):463-6. [Medline].

  4. Biyani CS, O'Connor JP, Browning AJ. Laparoscopic removal of retained nephrostomy tubing. J Urol. Sep 2003;170(3):916-7. [Medline].

  5. Bloom DA, Morgan RJ, Scardino PL. Thomas Hillier and percutaneous nephrostomy. Urology. Apr 1989;33(4):346-50. [Medline].

  6. Carson CC, Little N. The absolute and relative contraindications to ESWL. In: Problems in Urology. Vol 1. Philadelphia, Pa: JB Lippincott Co; 1987:580.

  7. Clayman RV, Kavoussi LR. Endosurgical techniques for noncalculous disease. In: Campbell's Urology. 7th ed. Philadelphia, Pa: WB Saunders Co; 1992:2235-45.

  8. Coleman CC, Kimura Y, Reddy P. Complications of nephrostolithotomy. Sem Intervent Radiol. 1984;1:24.

  9. Grasso M, Loisides P, Beaghler M, et al. The case for primary endoscopic management of upper urinary tract calculi: I. A critical review of 121 extracorporeal shock-wave lithotripsy failures. Urology. Mar 1995;45(3):363-71. [Medline].

  10. Grasso MG, Taylor F. Techniques for percutaneous renal access. In: Sosa RE, Albala DM, eds. Textbook of Endourology. Philadelphia, Pa: WB Saunders Co; 1996.

  11. Kaskarelis IS, Papadaki MG, Malliaraki NE, et al. Complications of percutaneous nephrostomy, percutaneous insertion of ureteral endoprosthesis, and replacement procedures. Cardiovasc Intervent Radiol. Jul-Aug 2001;24(4):224-8. [Medline].

  12. Kavanagh DO, Fanning N, Heffernan E, et al. Management of gestational nephrolithiasis in the presence of a bicornuate uterus and pelvic kidney. Int J Urol. Feb 2005;12(2):211-3. [Medline].

  13. Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol. Oct 2004;18(8):715-22. [Medline].

  14. Lam HS, Lingeman JE, Mosbaugh PG, et al. Evolution of the technique of combination therapy for staghorn calculi: a decreasing role for extracorporeal shock wave lithotripsy. J Urol. Sep 1992;148(3 Pt 2):1058-62. [Medline].

  15. LeRoy AJ, Williams HJ Jr, Bender CE, et al. Colon perforation following percutaneous nephrostomy and renal calculus removal. Radiology. Apr 1985;155(1):83-5. [Medline].

  16. Little B, Ho KJ, Gawley S, et al. Use of nephrostomy tubes in ureteric obstruction from incurable malignancy. Int J Clin Pract. Apr 2003;57(3):180-1. [Medline].

  17. Mariappan P, Smith G, Bariol SV, et al. Stone and pelvic urine culture and sensitivity are better than bladder urine as predictors of urosepsis following percutaneous nephrolithotomy: a prospective clinical study. J Urol. May 2005;173(5):1610-4. [Medline].

  18. Motola JA, Smith AD. Therapeutic options for the management of upper tract calculi. Urol Clin North Am. Feb 1990;17(1):191-206. [Medline].

  19. Picus D, Weyman PJ, Clayman RV, et al. Intercostal-space nephrostomy for percutaneous stone removal. AJR Am J Roentgenol. Aug 1986;147(2):393-7. [Medline].

  20. Segura JW. Percutaneous management. In: Campbell's Urology. 7th ed. Philadelphia, Pa: WB Saunders; 1992:2183-94.

  21. Segura JW, Preminger GM, Assimos DG, et al. Nephrolithiasis Clinical Guidelines Panel summary report on the management of staghorn calculi. The American Urological Association Nephrolithiasis Clinical Guidelines Panel. J Urol. Jun 1994;151(6):1648-51. [Medline].

  22. Smith AD. Management of iatrogenic ureteral strictures after urological procedures. J Urol. Dec 1988;140(6):1372-4. [Medline].

  23. Strohmaier WL, Giese A. Ex vivo training model for percutaneous renal surgery. Urol Res. Jun 2005;33(3):191-3. [Medline].

  24. Tanaka T, Yanase M, Takatsuka K. Clinical course in patients with percutaneous nephrostomy for hydronephrosis associated with advanced cancer. Hinyokika Kiyo. Jul 2004;50(7):457-62. [Medline].

  25. Whitaker RH. An evaluation of 170 diagnostic pressure flow studies of the upper urinary tract. J Urol. May 1979;121(5):602-4. [Medline].

  26. Zagoria RJ, Dyer RB. Do's and don't's of percutaneous nephrostomy. Acad Radiol. Jun 1999;6(6):370-7. [Medline].

Further Reading

Keywords

nephrostomy, nephrostomy tube, percutaneous renal access, renal drainage, percutaneous endourology, urinary drainage, ureter obstruction, ureteral obstruction, intracorporeal lithotripsy, chemical stone dissolution, double-J stent placement, Ormond disease, ovarian tumors, sarcomas, intraperitoneal tumors, vascular surgery, aortofemoral bypass, ureteropelvic junction obstruction, UPJ obstruction, flexible antegrade pyeloureteroscopy, upper urinary tract obstruction, percutaneous nephrostomy, horseshoe kidneys

Contributor Information and Disclosures

Author

Stefan H Hautmann, MD, PhD, Assistant Professor, Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel Campus, Germany
Disclosure: Nothing to disclose.

Coauthor(s)

Raymond J Leveillee, MD, FRCS(Glasg), Professor of Clinical Urology, Radiology and Biomedical Engineering, Department of Urology, University of Miami Miller School of Medicine; Chief, Division of Endourology/Laparoscopy and Minimally Invasive Surgery, Department of Urology, Jackson Memorial Hospital
Raymond J Leveillee, MD, FRCS(Glasg) is a member of the following medical societies: American Urological Association, Endourological Society, Sigma Xi, and Society of Laparoendoscopic Surgeons
Disclosure: ACMI/Gyrus Honoraria Speaking and teaching; Boston Scientific Honoraria Speaking and teaching; Applied Medical Honoraria Speaking and teaching; Intuitive Surgical  Honoraria Speaking and teaching; LMA suisse Grant/research funds Consulting; Pluromed Grant/research funds Consulting

Medical Editor

Raymond Rackley, MD, Professor of Surgery, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University; Staff Physician, Center for Pelvic Medicine and Pelvic Reconstruction, Glickman Urological Institute, Cleveland Clinic Foundation
Raymond Rackley, MD is a member of the following medical societies: American Urological Association
Disclosure: Pfizer, Novartis, Proctor & Gamble, Allergan Honoraria None; Pfizer, Novartis, Proctor & Gamble, Allergan Consulting fee Other

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Shlomo Raz, MD, Professor, Department of Surgery, Division of Urology, University of California at Los Angeles School of Medicine
Shlomo Raz, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, and California Medical Association
Disclosure: Nothing to disclose.

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

Chief Editor

Bradley Fields Schwartz, DO, FACS, Associate Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine
Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, and Society of University Urologists
Disclosure: Nothing to disclose.

 
 
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