Obstructive uropathy due to stone disease is seen every day in urological practice. Percutaneous nephrostomy and double j ureteral stent procedures are used.
A randomized controlled trial was conducted in one center from January 2021 to January 2022. A total of 104 patients of age ≥18 years who had unilateral or bilateral obstructive uropathy due to stone disease were divided into two groups. In Group A, 50 patients underwent to double j stent while in Group B, 54 patients who underwent percutaneous nephrostomy insertion tube. Under local anesthesia, the stent was inserted by cystoscopy. While the percutaneous nephrostomy was done under ultrasound guidance by using local anesthetic agent. Complications were noted in immediate postoperative period and on follow up.
Mean age of Group A was 35 ± 12.7 years whereas mean age in Group B was 36.7 ± 12.5 years and 49 out of patients were male. The most common complication in double j group and nephrostomy group was hematuria (16% and 5.5% respectively). Post DJ stent, complications like septicemia, painful trigon irritation, and stent encrustation were seen in 8.0%, 10.0%, 10.0% and 4.0% patients respectively. On the other hand, post-PCN septicemia, tube dislodgment or blockage, and injury to adjacent organs were seen in 3.7%, 5.5% and 1.8% respectively. In our trial, overall success rate for double j stenting was up to 84.0% and for percutaneous nephrostomy (PCN) was 96.29% (p < 0.0001).
We found percutaneous nephrostomy is better and had overall higher success rate with less complications post procedure.
Annals of medicine and surgery (2012). 2022 Aug 26*** epublish ***
Maher Al-Hajjaj, Aziz Joseph Sabbagh, Ibrahim Al-Hadid, Mohamed Taher Anan, Mohammad Nour Kazan, Ali Alali Aljool, Hasan Al Muhammad Al Husein, Mohamed Tallaa
Department of Urology, University of Aleppo, Aleppo, Syria., Department of Statics, University of Aleppo, Aleppo, Syria., Department of Internal Medicine, Al-Moujtahed Hospital, Damascus, Syria.