Percutaneous nephrostomy (PCN) is a minimally invasive radiological procedure used to drain urine from the kidney when there is obstruction in the urinary tract. This obstruction may be due to various reasons such as kidney stones, tumors, or strictures.

Percutaneous nephrostomy is generally considered safe and effective for relieving urinary obstruction and can provide significant relief to patients experiencing kidney-related issues. However, like any medical procedure, there are risks involved, such as bleeding, infection, or injury to surrounding structures, which are typically minimized through careful technique and patient selection.

Here’s a general overview of the percutaneous nephrostomy procedure:

1. Imaging Guidance – The interventional radiologist uses imaging techniques such as fluoroscopy (real-time X-ray) and ultrasound to guide the insertion of the needle into the kidney.
2. Insertion of Needle – A small incision is made in the skin, and a thin needle is inserted through the skin and into the kidney under the guidance of imaging. Once the needle is in the correct position within the kidney, a wire is passed through it and into the collecting system of the kidney.
3. Dilation and Catheter Placement – Over the wire, a series of dilators are passed to enlarge the tract. Then, a drainage catheter (a flexible tube) is inserted through the dilated tract and into the kidney to drain urine. The catheter is secured to the skin with sutures or adhesive dressing.

Before the procedure, the patient’s medical history is reviewed, and they may undergo blood tests and imaging studies (such as CT scans or ultrasound) to determine the location and severity of the obstruction.

The patient is typically placed in a prone position (lying face down) on the operating table. Local anesthesia and moderate sedation is administered to numb the area where the procedure will be performed.

After the catheter is placed, its position is verified using imaging to ensure proper drainage. The catheter is connected to a drainage bag to collect urine. The patient is monitored for any complications and given instructions on caring for the catheter.

Depending on the patient’s condition, further imaging or procedures may be necessary to address the underlying cause of the obstruction.

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