Pediatric percutaneous nephrostomy: experience with 50 patients.

Percutaneous nephrostomy tube placement was performed on 50 children with obstructed urinary tracts. The youngest patient was 3 days old and the smallest weighed 1,400 gm. The most common indication was obstruction after ureteral reimplantation (17 cases) followed by preoperative placement for pelvioureteral junction obstruction (15 cases). Infection was the most common presenting feature (14 cases), followed by a mass (11 cases) and renal failure (11 cases). Catheter placement was performed with basal sedation and general anesthesia was not used. There were no failures. In 26 patients no further surgery was required, including 16 of the 17 patients who had obstruction secondary to ureteral reimplantation. The only 2 significant complications were sepsis after catheter exchange in 1 patient and brisk hematuria upon placement of the catheter in another patient. Percutaneous nephrostomy tube placement is the method of choice for temporary relief of obstruction of the upper urinary tracts in children, since the hazards of surgery and general anesthesia are avoided.