Informed consent from the patient should be taken before the procedure. Besides, intravenous access and antibiotics should be given half an hour before the procedure for those with underlying urinary infection. Then the subject lie down in prone position with the side to be operated on lie at the edge of the table. The area is then cleaned and draped. If the subject is unable to lie down prone due to underlying heart or lung problem, the supine position can also be used. An area for needle insertion is marked at the region with four sides, namely: upper margin are the borders of 11th and 12th ribs, lower margin is the iliac crest, medial margin is marked by the muscles beside the spine, and lateral margin is marked by the posterior axillary line. The puncture area is the located using ultrasound. Local anaesthetic is then injected around the area and scalpel incision is made. An 18 G trocar needle is inserted into the puncture site. The operator can feel two "pop"s while inserting the needle, one is when passing through the renal capsule, and another one is when entering the collecting system. Then urine is aspirated from the collecting system and sent for culture. If the urine is clear, then dye is injected into the system for delineation of calyceal system. If the urine is turbid, dye should not be injected into the collecting system to prevent the spread of infection.
Percutaneous nephrostomy
Percutaneous nephrolithotomy
Nephrostomy
Ureteric stent
Ureteric balloon catheter
Urostomy
Ureteroureterostomy
Ureterolysis