Objective: Acute upper urinary tract obstruction due to stones is treated with surgical decompression with percutaneous nephrostomy catheter (PNC) or retrograde ureteral stent (RUS). There is not enough data to show the superiority of these two treatments. In this study, we aimed to compare the two treatment approaches in terms of success and complications.
Material and Methods: Between January 2017 and January 2022, patients who underwent emergency JJ stent and emergency nephrostomy catheter insertion due to ureteral stones in a tertiary healthcare institution were retrospectively analyzed. Patients who underwent intervention for reasons other than ureteral stones, pregnant patients, patients under 18 years of age, patients with coagulopathy and patients with chronic renal failure were excluded. A total of 131 patients, including 112 patients in the JJ stent group and 19 patients in the nephrostomy group were included in the study.
Results: Statistically higher creatinine levels were found in the JJ stent group in the 12th hour post-treatment comparison (p=0.042). There was no difference between the groups in creatinine values at the 48th hour after treatment (p=0.579). The intraoperative complication rate was 14.3% in the JJ stent group, compared to 10.5% for the nephrostomy group. There was no statistically significant difference between the groups (p=0.660). Postoperative complication rates were statistically similar between the groups (p=0.490).
Conclusion: In cases where urgent surgical decompression is required, PNC or RUS placement are equally effective and reliable treatments for the management of the disease. There is no significant difference between the two treatment approaches in terms of complications.
Abstract
Objective: Acute upper urinary tract obstruction due to stones is treated with surgical decompression with percutaneous nephrostomy catheter (PNC) or retrograde ureteral stent (RUS). There is not enough data to show the superiority of these two treatments. In this study, we aimed to compare the two treatment approaches in terms of success and complications.
Material and Methods: Between January 2017 and January 2022, patients who underwent emergency JJ stent and emergency nephrostomy catheter insertion due to ureteral stones in a tertiary healthcare institution were retrospectively analyzed. Patients who underwent intervention for reasons other than ureteral stones, pregnant patients, patients under 18 years of age, patients with coagulopathy and patients with chronic renal failure were excluded. A total of 131 patients, including 112 patients in the JJ stent group and 19 patients in the nephrostomy group were included in the study.
Results: Statistically higher creatinine levels were found in the JJ stent group in the 12th hour post-treatment comparison (p=0.042). There was no difference between the groups in creatinine values at the 48th hour after treatment (p=0.579). The intraoperative complication rate was 14.3% in the JJ stent group, compared to 10.5% for the nephrostomy group. There was no statistically significant difference between the groups (p=0.660). Postoperative complication rates were statistically similar between the groups (p=0.490).
Conclusion: In cases where urgent surgical decompression is required, PNC or RUS placement are equally effective and reliable treatments for the management of the disease. There is no significant difference between the two treatment approaches in terms of complications.