Use of a lockable pigtail catheter (Cook Dawson-Mueller Multipurpose Drainage Catheter) for nephrostomy reduces the risk of slippage of the catheter

Abstract

Objective: This study compared the outcomes of using Mac-Loc catheters and non–Mac-Loc catheters for percutaneous nephrostomy (PCN). Mac-Loc catheters have a locking mechanism that forms a curl at the tip by pulling a suture and securing it in place.

Methodology: This retrospective study compared the outcomes of consecutive patients who received PCN with catheters equipped with Mac-Loc versus those with catheters without Mac-Loc. Catheter failure was the primary endpoint of the study and was defined as all cases of catheter malfunction after PCN. A propensity score was calculated from covariates based on clinical variables, and patients in each group were matched 1:1 based on the propensity score.

Results: During the follow-up period, a total of 289 cases underwent PCN, 72 with catheters equipped with Mac-Loc and 217 without Mac-Loc. Failure of the catheter occurred in 63 cases (22%). There were 44 cases (70%) of slippage, 18 cases (29%) of obstruction, and 1 case (2%) of catheter rupture. After propensity score matching, catheter failure–free survival was significantly higher in the group with catheters equipped with Mac-Loc than in the group without Mac-Loc (P = .003).

Conclusions: The use of catheters equipped with Mac-Loc for PCN reduces the risk of unintentional catheter slippage.

Keywords

catheter / nephrostomy / percutaneous nephrostomy / ureteral obstruction / urology

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2023 College of Surgeons of Hong Kong.