fercutaneous nephrostomy (PCN) is an established technique in urology but there have been few reports in pediatric urology. We reviewed retrospectively 48 cases for evaluation of the indication, results, complications, and the methods of
follow-up
after
PCN.
From October ＇85 to December ＇95, on 50 kidneys of 48 patients, 64 PCN were performed. male patients were predominant (39:9). The indication of PCN were the functional edvaluation of huge hydronephrotic kidneys (23 PCN), the relieve of urinary
obstruction (10), the urinary diverdsion (9), the urinary tract infection (110, the differantial dagnosis of hydronephrosis (1) and re-PCN after cathter displacement or obstruction (10).
23 patients for the functional evaluation evaluation of huge hydronephrotic kidneys that had poor function in the intravenous pyelography or the radioisotope renal scan, and/or the thin parenchyme din ultrasound, had got the regular follow-up
with
check
of the daily urine output, the creatinine clearance after 2-14 days. 19 who showed good urine output (200-1000ml/day) and good creatinine clearance (average 22.4% of total creatinine clearance) after 2-14 days, were managed by reconstructive
surgery and
nephrectomy was performed in 4 patients who poor urine output (less than 10 ml/day0 or poor creatinine clearance( 1.1 and 3.5% of total creatinine clearance0.
After PCN, there were mild infection in 3 cases and no serious complication. But there were catheter displacement in 13 cases and catheter obstruction in 3 cases, and in 13 cases of catheter displacement, 8 (53.3%, 8/15) were under 1 year-old, 4
(25%,
4/16) were between 1 and 5 year-old, and 1 (5.9%, 1/17) was over 6 year-old. In 2 cases of UPJ obstruction, the thickening of renal pelvis had made pyeloplasty difficult.
Our data shows that brief period (within 2 weeks) of nephrostomy drainage allows the kidney to display its potential for recovery of function, as measured by differencial creatinine clearance and daily urine output. In pediatrics, PCN should be
performed carefully in the selected cases and the duration of nephrostomy should be shortened as possible.
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