Efficacy and safety of renal drainage options for percutaneous nephrolithotomy

Torres, João Pimentel; Oliveira, João N; Morais, Normanda Araújo de; Anacleto, Sara; Rodrigues, Ricardo; Mota, Paulo; Leão, Ricardo; Lima, Estêvão

doi:10.23736/s0393-2249.19.03643-9

Cited by 7 publications

(2 citation statements)

References 27 publications

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“…This requires an additional visit/procedure for flexible cystoscopy and stent removal and exposes patients to documented associated risks of storage lower urinary tract symptoms, back pain, hematuria, and urinary tract infection. [6][7][8][9] Prior studies performed for other renal stone procedures have confirmed that overnight stenting 10 or even no stenting 11 can be feasible and safe, while others have concluded that it may result in increased ED visits or telephone calls for pain. 12 Due to the general acceptance of short-term stent dwell times, 4,13,14 we now elect in the majority of our cases at our institution to leave the tether attached to the ureteral stent and remove it on postoperative day one (POD1) if the patient meets predetermined criteria including adequate pain control and appropriate resolution of hematuria.…”

Section: Introductionmentioning

confidence: 99%

POD1 Stent Removal after PCNL

Mershon

Goodstein

Khuhro

et al. 2023

Journal of Endoluminal Endourology

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Introduction: Percutaneous nephrolithotomy (PCNL) is the gold standard for treating large or complex renal stones. Renal drainage after the procedure is most commonly via nephrostomy tube or indwelling ureteral stent, but the optimal duration of ureteral stents after PCNL is currently unknown. This study describes the post-operative events occurring with early stent removal on post-operative day one (POD1) in patients undergoing uncomplicated PCNL. Methods: We identified 336 patients from a single institution that underwent PCNL between 1/1/2020 and 6/1/2021. Of these, 106 patients with uncomplicated procedures that met inclusion criteria for early stent removal on POD1 were included. Retrospective chart review was performed to collect demographic information, operative data, and to identify adverse outcomes including additional procedures, patient telephone calls for symptoms, complications and emergency department (ED) visits. Results: Mean (SD) patient age was 54 (15.1) years and 56% of patients were morbidly obese (Body Mass Index [BMI] >30). Overall post-operative complication rate was low (18.8%) and limited primarily to Clavien I/II complications with only two Clavien III (1.9%) complications. Telephone calls or electronic messages were received from 37.7% of patients, with 16% requiring a visit to the ED or clinic. The most common reason for an ED visit was flank pain (11.1%). Conclusions: Early stent removal on POD1 may lead to pain-related telephone calls but appears to be a generally safe and effective management option in carefully selected patients undergoing uncomplicated PCNL.

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Section: Introductionmentioning

confidence: 99%

POD1 Stent Removal after PCNL

Mershon

Goodstein

Khuhro

et al. 2023

Journal of Endoluminal Endourology

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“…The stone disintegration and evacuation of the generated stone fragments can be achieved with various lithotripsy technologies [7]. Likewise, different drainage options following the PCNL have been proposed [8].…”

Section: Introductionmentioning

confidence: 99%

Electromagnetic-guided puncture: a tool or a tale?

Tsaturyan

Liatsikos

Faitatziadis

et al. 2022

Current Opinion in Urology

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Purpose of reviewThe puncture technique and site of the puncture can impact the clinical outcome and the development of postoperative adverse events following percutaneous nephrolithotomy (PCNL). The aim of the current review was to discuss the available puncture guidance approaches and outline the potential role of the recently introduced electromagnetic-guided method. Recent findingsThe puncture and PCNL tract establishment is usually performed using fluoroscopic or ultrasound guidance or a combination of two approaches. Electromagnetic-guided puncture is one of the most recent advancements of technology. The puncture navigation to the renal collecting system is available after placing a special wire with an electromagnetic tracking sensor into the desired calyx through the flexible ureterorenoscope. The available experimental and clinical studies have shown a high first puncture rate, decreased median time for obtaining a puncture, and shorter learning curves for beginners. SummaryFluoroscopic and ultrasound guidance are the main approaches used by urologists. However, these modalities require a steep learning curve, approximately 60 cases for reaching competency. The initial data on electromagnetic navigation have shown the feasibility and potential promising outcomes of this novel approach. New studies are required to investigate its potential implementation opportunities in the daily practice of urologists.

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