ENDOUROLOGICAL MANAGEMENT OF RETAINED SURGICAL DRAINS AND NEPHROSTOMYTUBES

A retained surgical drain or nephrostomy tube is a troublesome predica ment that often has necessitated open surgical extraction. To assess t he efficacy of endoscopic techniques in the management of this problem , several types of drains and tubes were placed intraperitoneally in a female pig and left for 3 weeks. Flat drains could be removed by trac tion. Jackson-Pratt drains could be removed by clearing the lumen of a morphous material with a guidewire and releasing the external adhesion s with a 9.5Fr rigid ureteroscope passed beside the tube. The retained re-entry nephrostomy tubes could be removed under fluoroscopic contro l by using stone-grasping forceps and electrocautery inside the tube t o incise the tissue holding the Malecot flanges. This latter method al so was successful in a patient who had received intracavitary BCG afte r percutaneous tumor resection. Endourologic techniques can reduce the number of open operations that need to be performed to remove retaine d drains and tubes.