Double J stenting compared with ureteral catheterization in percutaneous Nephrolithotomy

Abstract

Background: Nephrolithiasis represents a large portion in the fi eld of Urological pathology. Minimal invasive and non-invasive therapies have become more accessible and effi cient in the treatment of nephrolithiasis. Percutaneous nephrolithotomy (PCNL) is an effective minimal invasive modality of treating kidney stones. Objectives: To evaluate the outcome of standard percutaneous nephrolithotomy (PCNL) using two different stenting techniques i.e. externalized ureteral catheter placement compared with Double-J stent placement. Methods: This is a prospective study conducted from January 2012 to June 2013 at Kathmandu Medical College Teaching Hospital among patients undergoing percutaneous nephrolithotomy (PCNL). Fifty patients who underwent PCNL were divided into two equal groups: Group 1 (PCNL with Double-J stent placement) and Group 2 (PCNL with externalized ureteral catheter placement). Factors evaluated included stent-related symptoms, postoperative morbidity, and the cost. Morbidity was classifi ed according to the Modifi ed Clavien classifi cation. SPSS 20 was used for statistical evaluation. P value less than 0.05 was considered signifi cant. Results: Stent related morbidity were fever, dysuria, hematuria, burning micturition. Total of 16 stent related complications were seen in group 1 with four of the patients needing early surgical intervention to remove the Double J stent and injectable antibiotics for urinary tract complication due to indwelling stent. In Group 2, seven patients experienced postoperative complications, out of which six were managed conservatively and one patient had grade III A dysuria and hematuria, who underwent immediate stent removal and received injectable antibiotics. There was no reported sepsis and mortality in both groups. Stent was removed in 3-4 weeks' time in group 1 and 3-4 days in group 2. In Group 1, patients had to come one day prior for stent removal. Cost for DJ stent was signifi cantly higher in group I than group II. Conclusion: Standard PCNL with externalized ureteral catheter is as feasible as Double-J stenting. Less cost can be a huge relief to the patients in the third world developing country.

Comparative Study of Externalized Ureteral Catheter Versus Double-J Stent on Percutaneous Nephrolithotomy: A Randomized Controlled Trial

“…p=0.931), and length of hospital stay (5.70±2.72 days vs. 5.72±2.08 days, p=0.961) in both the groups [ 11 ]. Joshi et al in another similar study evaluated the outcome of standard PCNL using two different stenting techniques, i.e., externalized ureteral catheter placement compared with double-J stent placement and reported that 64% of patients showed stent-related symptoms in the double-J stenting group, while in the EUC group, 28% of patients experienced such complications [ 12 ].…”