Percutaneous nephrostomy in indicated in:
**Percutaneous Nephrostomy (PCN)**
**Core Concept**
Percutaneous nephrostomy is a minimally invasive procedure used to relieve urinary obstruction in patients with kidney stones, cancer, or other conditions that cause blockage of the ureter. It involves inserting a catheter through the skin into the kidney to drain urine directly into a collection bag.
**Why the Correct Answer is Right**
The correct answer is a condition where a patient has a complete obstruction of the ureter, preventing urine from flowing from the kidney to the bladder. This can occur due to kidney stones, tumors, or other anatomical abnormalities. In such cases, PCN helps to relieve the obstruction, preventing further kidney damage and reducing the risk of infection. The procedure is typically performed under imaging guidance, such as fluoroscopy or ultrasound, to ensure accurate placement of the catheter.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not provided.
**Option B:** While PCN can be used in patients with kidney stones, this is not the only indication. Other options are more specific to the procedure's benefits.
**Option C:** PCN is not typically used as a first-line treatment for urinary retention, as it may not address the underlying cause of the condition.
**Clinical Pearl / High-Yield Fact**
A key consideration in PCN is the risk of bleeding and infection. Patients with coagulopathy or a history of recent surgery may be at higher risk for complications, and antibiotic prophylaxis may be necessary to prevent infection.
**Correct Answer:** D.