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→Insertion of new catheter: Distinguished
*Insert the new catheter with obturator over the guidewire, keeping the same direction as the guidewire through the tissues to avoid pulling or kinking it.*
*Enter the renal pelvis with the obturator, and then advance with only the soft catheter.*
*If Confirm proper position of a pigtail catheter, lock the pigtail. If unsure, confirm location within the renal pelvis by injection of a few ml of contrast before fixation, with two projections from different directions.**Fixate the pigtail of the catheter.
*Confirm functionality by injection of a few ml of contrast, looking for spontaneous dripping from the catheter when left open, as well as aspiration of the contrast.* <br>Check whether there is blood or pus in the aspirate or spontaneous return.
*Attach the outside end of the catheter to a bag.<ref group=notes>Plug it only if there is a clear plan to attach a bag at a specific later time.</ref>
