Nephrostomy tube drainage with pyeloplasty: Is it necessarily a bad choice?

Paul F. Austin, Mark P. Cain, Richard C. Rink

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Purpose: Despite continued controversy regarding the optimal method of urinary diversion after dismembered pyeloplasty in children, we have treated the majority of our patients with postoperative nephrostomy tubes and no stents. We report our experience. Materials and Methods: The records of all patients who underwent surgery for ureteropelvic junction obstruction from August 1985 to October 1998 and were treated only with a nephrostomy tube after pyeloplasty were reviewed for hospital course, complications and postoperative followup. All patients had a perinephric Penrose drain as well as a Foley catheter placed for bladder drainage. Results: A total of 137 pyeloplasties were performed in 132 patients, including 5 with bilateral ureteropelvic junction obstruction, using only nephrostomy tube drainage with an average followup of 2.1 years. Initial nephrostograms demonstrated good drainage across the repair with no extravasation in 91% of patients. Subsequent nephrostograms revealed a widely patent anastomosis in the remaining cases. No patient had postoperative obstruction, or required secondary pyeloplasty or nephrectomy. Urinary tract infection developed in 2 patients (1.5%). Mean hospitalization was 4.4 days. There was a significant difference in length of stay in the last 5 years compared to that in previous years (3.4 versus 5.8 days, p <0.05) and hospital stay continues to decrease. Conclusions: Use of only a nephrostomy tube after pyeloplasty resulted in few complications and an open anastomosis in 100% of cases. Nephrostomy drainage not only serves as a protective mechanism, but also allows easy access for radiographic studies before removal of the tube. In addition, nephrostomy tube drainage does not prolong hospitalization and the tube may be easily removed on an outpatient basis without further anesthesia.

Original languageEnglish
Pages (from-to)1528-1530
Number of pages3
JournalJournal of Urology
Volume163
Issue number5
StatePublished - May 2000

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Drainage
Length of Stay
Hospitalization
Urinary Diversion
Nephrectomy
Urinary Tract Infections
Stents
Urinary Bladder
Outpatients
Catheters
Anesthesia

Keywords

  • Drainage
  • Kidney
  • Surgical anastomosis
  • Urinary diversion

ASJC Scopus subject areas

  • Urology

Cite this

Austin, P. F., Cain, M. P., & Rink, R. C. (2000). Nephrostomy tube drainage with pyeloplasty: Is it necessarily a bad choice? Journal of Urology, 163(5), 1528-1530.

Nephrostomy tube drainage with pyeloplasty : Is it necessarily a bad choice? / Austin, Paul F.; Cain, Mark P.; Rink, Richard C.

In: Journal of Urology, Vol. 163, No. 5, 05.2000, p. 1528-1530.

Research output: Contribution to journalArticle

Austin, PF, Cain, MP & Rink, RC 2000, 'Nephrostomy tube drainage with pyeloplasty: Is it necessarily a bad choice?', Journal of Urology, vol. 163, no. 5, pp. 1528-1530.
Austin, Paul F. ; Cain, Mark P. ; Rink, Richard C. / Nephrostomy tube drainage with pyeloplasty : Is it necessarily a bad choice?. In: Journal of Urology. 2000 ; Vol. 163, No. 5. pp. 1528-1530.
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