[Use of pyelomanometry and roentgenological and television uroscopy in determining the time for nephrostomy closing].

Abstract

To evaluate objectively the degree of the urodynamics recovery in patients with nephrostomy in the postoperative period and to determine the optimal times of removing the nephrostomy drainage tubes, a ++video-urodynamic study was carried out. It consisted in combined antegrade X-ray TV ++pyelo-ureteroscopy and ++trans-fistula pyelomanometry. To measure the degree of the effect of retroperitoneal pressure on urodynamics, intraperitoneal pressure was also evaluated. The volumetric rate of the perfusion of the radiographic contrast substance ranged from 1 to 7 ml/min. As many as 108 patients with nephrostomy were examined within different times after the operation. Urodynamics was regarded as recovered, if the difference between pelvic and intraperitoneal pressure did not exceed 12 cm H2O, with the volumetric rate of perfusion being different. In 76/108 patients (70.4%), adequate passage of urine in the ++upper urinary tract was determined, which allowed one to attempt nephrostomy closing. In 32/108 patients (29.6%), the results of the study were viewed as unsatisfactory which required continuation of the draining of the pelvi-calyceal system by the nephrostomic drainage tubes. Repeated investigation carried out after 5-10 days revealed the normalization of the urodynamic characteristics. No complications were recorded after the nephrostomic drainage tubes were removed.