Percutaneous Nephrostomy Experience Among Urologists in Türkiye

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Abstract
Urinary tract obstruction, resulting from various etiologies, is a significant clinical condition associated with substantial morbidity, including life-threatening sepsis and acute kidney injury. Prompt intervention for decompression via ureteral stenting or percutaneous nephrostomy is paramount. This study aimed to assess the practice patterns of urologists in Türkiye concerning percutaneous nephrostomy and to highlight its integral role within urological clinical practice. A cross-sectional study was conducted between 7th May 2022 and 31st May 2023 following institutional ethics committee approval. A 13-item questionnaire was distributed to 131 urologists of various academic ranks. The data were analyzed using the chi-square test. Of the respondents, 71% (n=92) reported competency in performing percutaneous nephrostomy, while 29% (n=38) indicated they could not. Regarding the ideal provider for percutaneous nephrostomy, 31% (n=41) advocated for urologists, 11% (n=14) for interventional radiologists, and 58% (n=76) supported a collaborative approach between both specialties. When asked about institutional practice patterns, 11% (n=14) reported that percutaneous nephrostomy was not performed, 38% (n=50) noted it was performed by urologists, 24% (n=31) by interventional radiologists, and 28% (n=36) by both specialties. Notably, 55% of urologists who do not perform percutaneous nephrostomy, regardless of academic rank, cited malpractice concerns as the primary reason. Percutaneous nephrostomy remains a fundamental procedure in urological clinical practice. Our findings suggest that its inclusion in urology residency training curricula is vital to ensure urologists retain their competency in percutaneous nephrostomy management. Comprehensive training and proficiency in percutaneous nephrostomy should be a core component of urology residency programs.