Objective: To compare the complications rate of percutaneous nephrostomy and double J ureteral stenting in the management of obstructive uropathy.
Methodology: Total number of 300 patients of age 20-80 years who underwent JJ stenting or percutaneous nephrostomy for obstructive uropathy were included in this study. Patients were divided in two groups i.e. A & B. In group A, 100 patients who underwent double J ureteral stenting while in group B, 200 patients who underwent percutaneous nephrostomy tube insertion were included. The stent was inserted retrograde by using cystoscope, under mild sedation or local anesthesia. While the percutaneous nephrostomy was done under ultrasound guidance by using local anesthetic agent. Complications were noted in immediate post-operative period and on follow up.
Results: Majority of the patients were between 36 to 50 years of age with male to female ratio was 2.6:1. The most common cause of obstructive uropathy was stone disease i.e. renal, ureteric or both. Post DJ stent, complications like painful trigon irritation, septicemia, haematuria and stent encrustation were seen in 12.0%, 7.0%, 10.0% and 5.0% patients respectively. On the other hand, post-PCN septicemia, bleeding and tube dislodgment or blockage was seen in 3.5%, 4.5% and 4.5% respectively. In this study, overall success rate for double J stenting was up to 83.0% and for percutaneous nephrostomy (PCN) was 92.0% (p< 0.0001).
Conclusion: Percutaneous nephrostomy is a safe and better method of temporary urinary diversion than double J stenting for management of obstructive uropathy with lower incidence of complications.
Written by:
Ahmad I, Saeed Pansota M, Tariq M, Shahzad Saleem M, Ali Tabassum S, Hussain A. Are you the author?
Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan; Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan; Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan; Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan; Department of Urology and Renal Transplantation; Department of Urology and Renal Transplantation, Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, Pakistan.
Reference: Pak J Med Sci. 2013 May;29(3):725-9.
PubMed Abstract
PMID: 24353616
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