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Percutaneous nephrostomy is a minimally invasive procedure that involves the insertion of a catheter through the skin into the renal pelvis of the kidney, allowing for the drainage of urine when normal urinary flow is obstructed. This technique is often employed in cases where there are obstructions in the urinary tract due to conditions such as kidney stones, tumors, or strictures. The procedure typically begins with the patient lying in a comfortable position, often under local anesthesia, though sedation may also be used depending on the patient's situation and the physician's discretion. Imaging guidance is crucial during the procedure; ultrasound or fluoroscopy is frequently utilized to accurately locate the kidney and to guide the catheter placement. The physician makes a small incision in the skin, usually in the flank area, and carefully advances a needle through the skin and into the renal pelvis. Once the renal pelvis is accessed, a guidewire is threaded through the needle, which is then removed, and a larger catheter is placed over the guidewire. This catheter is left in place to allow urine to drain from the kidney into an external collection bag, thus alleviating pressure and reducing the risk of kidney damage or infection. Post-procedure, patients are monitored for any complications such as bleeding, infection, or catheter obstruction. Percutaneous nephrostomy can provide immediate relief in obstructive uropathy and can also serve as a bridge to more definitive treatments such as stone removal or surgical intervention. It is important to counsel patients regarding potential risks associated with the procedure, including the possibility of perforation of the kidney or surrounding organs, hematuria, and the need for ongoing care for catheter maintenance. The duration for which a nephrostomy tube remains in place can vary from days to weeks, depending on the underlying cause of obstruction and the patient's clinical condition. In many cases, this procedure significantly improves the patient's quality of life by alleviating symptoms such as pain and urinary retention. After the catheter is removed, patients typically undergo follow-up imaging to ensure that the underlying issue has been resolved. Overall, percutaneous nephrostomy is a valuable tool in the management of urinary tract obstructions, offering a safe and effective means of decompression in emergency and elective settings. The procedure plays a crucial role in preventing further renal damage and can sometimes be performed as a palliative measure in patients with advanced diseases, showcasing its versatility in renal care. The advent of percutaneous techniques has revolutionized the management of urinary tract disorders, making it an essential component of modern urology practice.