Should access for PCN be obtained through the renal parenchyma or directly into the renal pelvis

Should access for PCN be obtained through the renal parenchyma or directly into the renal pelvis?

Puncture of the collecting system should occur through the renal parenchyma because this is the least vascular plane. Direct access to the renal pelvis has a higher rate of vascular complications. Puncture through the renal parenchyma also helps to provide support for the catheter, minimize urine leakage, and decrease the chance of catheter displacement.

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