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Percutaneous interventional uroradiology

Department of Radiology, The Middlesex Hospital, London W1N 8AA

Correspondence: ^* Author for correspondence.

This excerpt was created in the absence of an abstract.

In the recent past, intervention in the urinary tract was the sole domain of the urological surgeon or the general surgeon with an interest in urology. With the advance of radiologically-guided interventional techniques, the approach is now multidisciplinary, involving surgeons, radiologists and pathologists. Some traditional methods of treating common urological complaints are now defunct. The implications of this are profound. They include shorter hospital inpatient stays, less use of general anaesthesia, easier planned patient management and, above all, decreased cost of patient treatment. Both patient morbidity and mortality have been reduced and, on the whole, the procedures are more acceptable.

Technology is advancing rapidly and newly acquired skills are often rather short-lived as primary therapeutic tools. For instance, extracorporeal lithotripters have reduced the demand for percutaneous nephrolithotomy, but such skills must still be practised and perfected for the treatment of complications and because not all patients are suitable.

This review concentrates on percutaneous renal work (Table I) and stresses current concepts. Specific interventional procedures are not described in detail.

Many interventional procedures, e.g. antegrade pyelography, can be performed on fluoroscopy units readily available in all X-ray departments. Ideally, a dedicated interventional suite is needed to satisfy both urologist and radiologist. The interventional room itself needs to be serviced by a recovery area and a nursing station where sterile trolleys can be prepared.

Received for publication July 1, 1988. Revision received February 1, 1989.