Percutaneous nephrostomy vs ureteral stent for hydronephrosis secondary to ureteric calculi: Impact on spontaneous stone passage and health-related quality of life – a prospective study

Morais, N.A. De Sousa; Pereira, João Pedro; Mota, Paulo; Carvalho-Dias, Emanuel; Torres, JC; Cordeiro, Anói Castro; Anacleto, Sara; Lima, Estevão

doi:10.1016/s1569-9056(19)30142-3

Cited by 1 publication

(3 citation statements)

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“…Yoshida et al concluded that in addition to the passive ureteral dilation caused by the ureteral stent, ureteral wall thickness is a substantial factor for spontaneous passage of ureteric stones ≤ 10 mm [27]. On the contrary, it was reported that spontaneous stone passage in patients with PCN was higher than in patients with RUS [8]. In our study, all patients in the RUS failure group had a static stone position after the initial drainage and before the definitive intervention.…”

Section: Discussioncontrasting

confidence: 44%

“…In another study, the mean stone size was 9.7 mm in patients who were selected for PCN placement versus 2.6 mm in patients managed by RUS. Additionally, the median surface area of the stone in patients selected for PCN placement was 92 mm 2 versus 47 mm 2 in patients managed by RUS [8,10].…”

Section: Discussionmentioning

confidence: 97%

“…Both radiologists and urologists have indicated that the choice of drainage method is largely influenced by personal assessment and stone size [8][9][10]. In most studies, the larger the stone size, the more likely it was that PCN was chosen as a drainage method.…”

Section: Abbreviationsmentioning

confidence: 99%

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Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy

Elbaset¹,

Edwan²,

Abouelkheir³

et al. 2021

Société Internationale D’Urologie Journal

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Objective: To define predictors for initial retrograde ureteral stenting (RUS) failure with the need for the percutaneous nephrostomy (PCN) insertion as a drainage method in patients with complicated acute calculus obstructive uropathy. Methods: We undertook a retrospective evaluation of patients who presented with complicated obstructive calculus uropathy (acute renal failure or obstructive pyelonephritis) between January 2016 and January 2020. Patients in whom there was failure to visualize ipsilateral ureteric orifice and those with extrinsic ureteral obstruction were excluded. Patient demographics and radiological data including stone site, hydronephrosis grade, maximum transverse stone diameter, periureteral density (PUD) and pericalcular ureteric thickness (P-CUT) at the maximum transverse stone diameter were assessed using non-contrast computed tomography at the time of admission. Results: The study included 256 patients who were managed initially by RUS trial. Of them, 48 (18.8 %) had RUS failure. The presence of acute pyelonephritis, increased maximum transverse stone diameter ≥ 9.5 mm, P-CUT ≥ 7.5 mm, and PUD at stone level ≥ 17.5 HU were risk factors associated with RUS failure (P = 0.007, 0.002, < 0.001, and < 0.001, respectively). Conclusion: Initial radiological stone and ureteric characteristics, in addition to the clinical diagnosis of obstructive pyelonephritis, can be used to determine PCN insertion as the preferred option over RUS for urinary drainage.

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Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 97%