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The Journal of Medical Research 2021; 7(3):79-82
Research Article
JMR 2021; 7(3):79-82
May- June
ISSN:2395-7565
© 2021, All rights reserved
www.medicinearticle.com
Received:12-04-2021
Accepted:23-05-2021
*Corresponding author:
Dr. Muhindo Valimungighe
Moise
Resident in General surgery of
CNHU-HKM in Cotonou,
Abomey Calavi University,
Republic of Benin and Faculty
of Medicine in University
Catholic of Graben, DRC
Email: drmoisev[at]gmail.com
Indications and outcomes of the percutaneous nephrostomy at
Urology-Andrology Teaching Hospital of CNHU-HKM in Cotonou
Hodonou Fred
1
, Chamutu Maheshe
2
, Yevi Magloire
1
, Agounkpe Michel Michael
3
, Muhindo Valimungighe
Moïse
4
, Natchagande Gilles
3
, Sossa Jean
3
, Avakoudjo D.G Josué
5
1
Senior Lecturer at Urology-Andrology Teaching Hospital of CNHU-Cotonou, Abomey Calavi University, Republic of
Benin
2
Resident at Urology-Andrology Teaching Hospital of CNHU-Cotonou, Abomey Calavi University, Republic of Benin
3
Lecturer at Urology-Andrology Teaching Hospital of CNHU-HKM in Cotonou, Abomey Calavi University, Godomey,
Benin
4
Resident in General surgery of CNHU-HKM in Cotonou, Abomey Calavi University, Republic of Benin and Faculty of
Medicine in University Catholic of Graben, DRC
5
Head, Department of Urology, Andrology Teaching Hospital /CNHU-HKM of Cotonou, Professor at Abomey Calavi,
University and President, Beninese Society of Urology, Benin
Abstract
Background: The percutaneous nephrostomy constitutes a backup remedy allowing the derivation of urine and thus
cancelling the emergency, while waiting for adequate etiological treatment. The objective of this study was to
determine indications and outcomes of the percutaneous nephrostomy at Urology-Andrology Teaching Hospital of the
National Centre Academic Hospital Hubert KOUTOUKOU MAGA (CNHU-HKM) of Cotonou. Methods: It was a
retrospective study carried out from January 1st, 2016 to May 30, 2020. Results: The placement of nephrostomy tubes
has been indicated in 15.26% of urine derivations for the obstruction of the upper urinary tract. The average age of
patients was 54.85 years with extremes of 28 and 70 years. The two sexes are interested in the same proportion, 10
cases for each. The average consultation time is 31.4 days with the extremes of 5 and 90 days. The obstruction was
bilateral in 19 cases on 20. The gynaecological cancers were majority with 9 cases follow-up of those of the colon (4
cases), of the bladder (3 cases) and of the prostate (3 cases). The drainage was unilateral in 18 cases out of 20. The
mean blood creatinine rate is 145.52 mg/l with extremes of 10 and 436 mg/l. Blood creatinine rate was pathological in
19 of our patients; it has been ameliorated among patients having an elevated initial creatinine blood level but without
reaching normal values in 18 out of 19 patients. The lowest rates of creatinine blood level have been reached after
10.33 days with extremes of 2 and 23 days. After the percutaneous nephrostomy, the surgical abstention has been
decided in 13 cases, the dialysis had been done in 5 cases, the reimplantation + installation of the probe double J in 1
case and the chemotherapy in 1 case. The main reason of death of the patients having undergone the nephrostomy was
the ionic disorders (13 cases out of 18) mainly the hyperkalemia and the hyponatremia followed of anemia (3 cases out
of 18) and of the uremic coma (2 cases out of 18). The middle duration of hospitalization after the drainage was of
16.85 days, with extremes of 1 and 50 days. The death occurred at 18 out of 20 patients and the middle period of
survival was 31.25 days with extremes of 1 to 60 days. Conclusion: The percutaneous nephrostomy remains the
beneficial alternative for the derivation of the upper urinary tract instead of the double J installation. Popularization of
percutaneous nephrostomy would reduce the morbidity and mortality linked to complications of obstructive syndrome
of the upper urinary tract; hence the need for awareness for early urological consultation.
Keywords: Percutaneous nephrostomy (PCN), Retrospective study, Double J probe.
INTRODUCTION
A true technical revolution developed in the 1960s
[1]
, percutaneous nephrostomy (NPC) constitutes a
backup remedy allowing the derivation of urine and thus cancelling the emergency, while waiting for an
adequate etiological treatment
[2]
. Simple gesture by well-trained hands under ultrasound control, it
requires very little equipment and allows, in local anesthesia to puncture a kidney whose cavities are
dilated or non-dilated
[3]
.
Emergency percutaneous nephrostomy improves kidney function by 100% in cases of obstructive anuria
[2]
. It can be performed in the context of an emergency (oligoanuria, pyonephrosis, etc.), for a therapeutic
purpose, but also to allow the diagnosis of a urological condition (opacification, etc.) or to provide
information on the quality punctured kidney (measurement of creatinine clearance) and even in the
context of palliative care
[4]
. The therapeutic failure of the installation of the JJ probe in our environment
requires the use of a percutaneous nephrostomy for a rapid derivation of urine.
The absence of data motivates this work which will evaluate percutaneous nephrostomy through its
indications as well as its outcomes and benefits in our workplace.