The safety and efficacy of ultrasound versus fluoroscopic percutaneous nephrostomy: A prospective randomized study

Faculty of Medicine

Assiut University

The safety and efficacy of ultrasound versus fluoroscopic percutaneous nephrostomy: A prospective randomized study

Research Authors
Ahmed M Moeen, Mostafa Kamel, Mahmoud Khalil, Fathy G Elanany, Mohamed Abdel Basir Sayed, Hosny M Behnsawy
Research Date
Research Department
Department of Urology
Research File
the_safety_and_efficacy_of_ultrasound_versus.16.pdf
Research Journal
Urology Annals
Research Member
Mostafa Kamel Abdel Rahman
Ahmed Mohamed Moeen / Ibrahim Ali
Hosny Mahmoud Ahmed Behnsawy
Fathy Gaber Mahmoud Alanany
Mohamed Abdel-Basir Sayed Hassan
Mahmoud Magdy Mahmoud Mohamed Khalil
Research Publisher
Medknow
Research Vol
15
Research Website
https://journals.lww.com/urol/fulltext/2023/04000/The_safety_and_efficacy_of_ultrasound_versus.16.aspx
Research Year
2023
Research_Pages
215-219
Research Abstract

Objective: 

The objective of this study is to compare the outcome of percutaneous nephrostomy by ultrasound (US) versus fluoroscopy including access time, volume of anesthesia required, success rate, and complications.

Methods: 

One hundred patients were enrolled in a prospective randomized study. Patients were divided into two groups, 50 cases each. Comparing the two groups was done regarding the need for dye, radiation effect, time taken, trial number, rate of complication, volume of anesthesia, and success rate.

Results: 

Patient demographics were comparable between both groups with no statistically significant difference. According to the modified Clavien–Dindo classification, the complications were Grade I (pain and mild hematuria) in each group. Procedural pain was present in 41 (82%) patients in Group I and in 48 (96%) patients in Group II. It was treated in both groups with a simple analgesic. Mild hematuria was present in 5 (10%) patients in the US group and 13 (26%) in the fluoroscopic group and treated by hemostatic drugs only. There was a statistically significant difference between both groups regarding the volume of required local anesthesia, the trial numbers, the puncture numbers, bleeding, extravasation, and change in the hemoglobin level.

Conclusion: 

US percutaneous renal access is a safe and effective modality with a high success rate, less operative time, and complication rate. However, a minimum of 50 cases with some pelvicalyceal system dilation may be preliminary requisites to achieve good orientation and competence in achieving safe US percutaneous renal access for future endourological procedures.