RETROGRADE NEPHROSTOMY - ADVANTAGES, DISADVANTAGES, AND THE LEARNING-CURVE

Establishment of a nephrostomy tract is a prerequisite for many endour ologic procedures of the upper urinary tract, We reviewed our initial experience with 31 retrograde nephrostomies to determine the advantage s and disadvantages and the learning curve for the procedure, All but one of the attempts were successful, and no complications were attribu table to the nephrostomy puncture, The procedure time averaged 21.1 mi nutes in nondilated collecting systems but 32.0 minutes in hydronephro tic kidneys (P < 0.01), The mean procedure time in our first 10 succes sful cases was 36.2 minutes, but it decreased to 22.6 minutes in the s econd 10 successful cases (P < 0.02), Radiation exposure was also mini mized early, with a mean fluoroscopy time of 3.5 minutes in our first 10 successful cases and 1.5 minutes in our second 10 successful cases (P < 0.02), Similarly, both procedure and fluoroscopy times decreased further in the most recent 10 successful cases, Retrograde nephrostomy is a safe procedure, is easier in a nondilated collecting system, and can be mastered with a short learning curve with minimal radiation ex posure.