Special Uses of Retrograde Percutaneous Nephrostomy in Endourology

Retrograde percutaneous nephrostomy (RPCN) allows the urologist to gain easy percutaneous access to the kidney. Generally there is no benefit of the retrograde approach over antegrade percutaneous nephrostomy except in special situations. We have described the technique of performing RPCN and reviewed its use in calyceal stones, upper ureteral stones, a nondistensible collecting system, hypermobile kidney and horseshoe kidney. In one highly selected patient who had a very hypermobile kidney RPCN resulted in a percutaneous nephropexy which totally alleviated her symptoms.