What is the procedure for dilation of kidney?

Percutaneous Nephrostomy (PCN):

Percutaneous nephrostomy (PCN) is a procedure commonly performed to relieve urinary obstruction and drain urine from the kidney, particularly in cases of kidney dilation or blockage. Here is an overview of the procedure:

1. Patient Preparation:

- The patient is informed about the procedure and asked to sign a consent form.

- Blood tests, urine tests, and imaging studies may be done to assess kidney function and anatomy.

- The patient is given antibiotics to prevent infection.

2. Anesthesia:

- General or local anesthesia may be used, depending on the patient's condition and preferences.

3. Imaging and Access:

- Ultrasound or fluoroscopy (X-ray guidance) is used to visualize the kidney and identify the appropriate location for puncture.

- A small incision is made in the skin, and a thin needle is inserted into the kidney under imaging guidance.

4. Placement of Guidewire:

- Once the needle is in the appropriate position, a guidewire is inserted through the needle into the renal pelvis (the collecting system inside the kidney).

5. Dilation and Sheath Insertion:

- Dilating devices are used to gradually enlarge the tract created by the needle, allowing for the insertion of a specialized sheath (a hollow tube) over the guidewire into the renal pelvis.

6. Contrast Injection:

- Contrast dye is injected through the sheath to obtain a detailed X-ray image (pyelogram) of the kidney and ureters, helping to identify any abnormalities or obstructions.

7. Nephrostomy Tube Placement:

- A nephrostomy tube (a thin, flexible tube) is inserted through the sheath into the renal pelvis. The tube exits through the puncture site in the back.

8. Balloon Inflation:

- A small balloon on the tip of the nephrostomy tube is inflated to secure the tube in place and prevent leakage of urine.

9. Tube Fixation:

- The nephrostomy tube is secured to the skin to ensure proper drainage of urine.

10. Imaging and Closure:

- A final X-ray is taken to confirm the correct positioning of the nephrostomy tube.

- The puncture site is covered with a dressing.

11. Post-Procedure Care:

- The patient is monitored closely for any signs of complications.

- Antibiotics are continued to prevent infection.

- The nephrostomy tube may be left in place for a few days to weeks, depending on the underlying condition.

- Regular imaging may be done to monitor the status of the kidney and the drainage.

PCN is a minimally invasive procedure with high success rates in relieving urinary obstruction and promoting kidney function. It allows urine to drain freely, resolving the dilation of the kidney and addressing related complications.