**1. Introduction**

296 Chronic Kidney Disease

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> Percutaneous nephrostomy (PCN) is a passageway that is introduced percutaneously into the renal pelvicalyces that can later be maintained by a tube, stent or catheter. Following its introduction by Wickbom in 1954 who described percutaneous puncture of the renal pelvis as a diagnostic procedure, Goodwin and Casey first described its therapeutic use for relief of urinary tract obstruction the following year in 1955 (Goodwin, Casey et al. 1955; Stables, Ginsberg et al. 1978). Since then, this now commonplace procedure has undergone significant progress in both its technical and imaging aspects, with improvisation of puncture devices and techniques, coupled with the advancing imaging modalities used to guide the procedure. Thanks to its good safety profile, percutaneous nephrostomy is the preferred technique for treatment of various urological conditions, and its pioneering role for relief of urinary tract obstruction remains in good use until today.

> This chapter aims to review the clinical use of percutaneous nephrostomy as well as the background technical aspects involved in carrying out the procedure. Some emphasis will be placed in the anatomical considerations that are crucial in determining approach as well as risk profile for an individual case. The associated known complications of the procedure will also be discussed, along with the therapeutic options available for the relevant complications.
