An instrument was developed to establish a tract through the muscle layer for percutaneous nephrostomy. The specially designed clamp holds a guide wire or rod and opens the muscle layer easily and safely. It is not as dangerous as a knife and is inexpensive compared with a disposable balloon dilator.

To cite: Chaudhary R, Modi JN, Jain N, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014206772 DESCRIPTION A 42-year-old woman presented with continuous urinary discharge from the vagina. She had undergone abdominal hysterectomy for adenomyosis and started leaking urine from the vagina on the 12th postoperative day. On per speculum examination, continuou...

BACKGROUND Percutaneous nephrolithotomy (PCNL) is a common endourologic procedure with less morbidity than open surgery. However, pain around the nephrostomy tube requires good post operative analgesia. So we hypothesize that infiltration of local anesthetic from the renal capsule to the skin around the nephrostomy tract would relieve the pain in the initial postoperative period. METHODS 60 a...

Prior to the introduction of antibiotics, the treatment of pyelonephrosis frequently consisted of nephrectomy to remove the non-functional kidney, which was a potentially dangerous source of systemic infection. This approach was later modified as a result of the advances made in antibiotic therapy, and included vigorous antibiotic treatment and prompt drainage of the kidney. At present, percuta...

Objective: We report a case involving a patient with bilateral emphysematous pyelonephritis (EPN) who was successfully treated with antibiotics and nephrostomy sparing nephrectomy. Case Presentation and Intervention: A 54year-old diabetic man presented with the chief complaint of progressive abdominal pain for 10 days. Blood tests indicated acute renal failure and hyperglycemic hyperosmolar sta...

OBJECTIVE To compare post-operative outcomes between tubeless and conventional large-bore nephrostomy tube drainage following percutaneous nephrolithotomy in children. METHODS The study comprised 54 patients under 14 years of age who were undergoing percutaneous nephrolithotomy at 60 renal units and met the inclusion criteria. They were randomised to placement of a 16F nephrostomy tube (Group...

Background. One of the life-threatening diseases among patients with a single kidney is acute purulent pyelonephritis (APP). The disease accompanied by oliguria or anuria and in many cases comes development multiple organ dysfunction. Objectives. To present features clinical manifestations APP solitary kidney, results laboratory examination, role imaging methods (USG, MRI contrast-enhanced CT) ...

BACKGROUND AND PURPOSE The role of early/emergency shockwave lithotripsy (SWL) in symptomatic upper ureteral calculi has still not been established. We have performed a randomized comparison between early (<48 hours) vs delayed (>48 hours) SWL for symptomatic upper ureteral stones less than 1 cm to evaluate the feasibility, safety, and efficacy of early SWL in these patients. PATIENTS AND MET...

Ureterocutaneous fistulas are rare, often iatrogenic complications. We present a case of a 60 year old woman suffering a ureterocutaneous fistula in association with an infected vascular graft. Percutaneous diversion of urinary fluid with a nephrostomy tube is an acceptable form of management.

OBJECTIVES (1) To evaluate the safety and efficacy of supine percutaneous nephrostomy, nephrolithotomy, and combined percutaneous nephrolithotomy and ureteroscopic lithotripsy. (2) To describe the skill-acquiring process in supine procedures and share our initial experience. DESIGN Three-staged case series with prospective data collection. SETTING Two public hospitals in Hong Kong. PATIEN...