Authors reply on "Percutaneous nephrostomy under ultrasound guidance".

Sir,

‘Percutaneous nephrostomy’[12] is a very effective procedure to relieve upper urinary tract obstruction temporarily, but is seldom practiced. Baishya et al.[1] correctly pointed out the benefits of the procedure under ultrasound guidance, as also particularly the risk of long-term radiation to the health personnel. The observations of the authors and that of Baishya et al.[1] are essentially similar. The debate between the proponents of the freehand technique and attached guide technique is age-old.[3] In our opinion, the freehand technique proves better in needle visualization and correct placement of the catheter. The Malecot catheter might be a better alternative in certain situations, where there is a significant chance of catheter blockage e.g. presence of pus or blood clot in the obstructed calyx.