Percutaneous nephrostomy application in pediatric age group

Background: In this study, aim is evaluation of percutaneous nephrostomy application in pediatric patients with urinary obstruction, effectiveness, feasibility, safety and clinical contributions. Materials and Methods: In our clinic, between dates of August 2011- July 2014, percutaneous nephrostomy applicated patients were retrospectively analyzed. Clinical, laboratory and radiological data were obtained from the patient files. Our screening process was performed using our hospital data processing system (HBYS). Demographic data, indications, changes in laboratory parameters, clinical observations, parameters such as the follow-up process was documented. Radiological data of the patients was obtained from the PACS system. Results: Percutaneous nephrostomy (PCN) was performed to ages 5 days-18 years ranging 49 pediatric patients, (32 male, 17 girls) totally 70 renal units with Hydronephrosis with different etiologies. Applications was performed with indications of diversion, drainage and diagnostic (49%, 35%, and 16% respectively). 5 patients were uremic. Of 18 patients who undergo PCN; have urinary stones (10 renal and 8 ureteral stones). Ureteropelvic junction obstruction (UPBO) was diagnosed in 16 patients, and ureterovesical junction obstruction (UVBO) in 7 patients. İn remaining 9 patients infravezikal obstruction, urinoma, perirenal hematoma, ureteral metastasis (osteosarcoma) diagnoses were identified. To 21 of patients, procedure applied urgently and others were in elective conditions. Emergent PCN decision was taken due to pyonephrosis, uremia and urinoma (12, 7 and 2 respectively). Major bleeding that require transfusion did not seen in our patients. A total of 12 patients (24%) showed decrease in HCT value (max 3). Avarage decrease of HCT was calculated as 0,4 in all cases. İn minor bleeded patient average loss of 1,8 hematocrit calculated. İn our patients we did not receive any other major complications such as sepsis, pneumothorax, colon injury etc. Results: İmaging-guided percutaneous nephrostomy procedure is an effective and inexpensive and safe, sometimes a lifesaving method that can be applied in the pediatric age group too.