The new hemostatic nephrostomy tube

Bleeding from the percutaneous access site is a common phenomenon, although clinically significant hemorrhage is fortunately a rare occurrence. We developed a new nephrostomy tube that combines the benefits of the re-entry nephrostomy tube with those of a balloon tamponade catheter. The 24 French Polyurethane tube has a 4.5 cm long balloon with a 45 F (15 mm) outer diameter which is positioned across the renal parenchymal access tract. A 14 cm tapered ureteral extension extends from a 4-winged malecot which lies in the renal pelvis. Five of 6 patients who had the tube placed post PCNL had only slightly blood-tinged urine drainage 2 hours after tube placement. It was well tolerated by all 6 and none of the patients required balloon re-inflation for delayed bleeding. The new nephrostomy tube can be used after most percutaneous renal operations. It is easy to insert, provides rapid and effective hemostasis of the access site and will allow for guidewire replacement down the ureter if future access should be necessary.