Comparison of complications rate between Double-J ureteral stent and percutaneous nephrostomy in obstructive uropathy due to stone disease: A comparative study.

Abstract

Background: Urolithiasis associated with obstructive uropathy appears to be a prevalent issue requiring effective methods for elimination of urinary blockage. The primary objective of this study was to assess the complication profile of PCN and DJ ureteral stenting in patients with stone related obstruction of the urinary tract.

Methods: The current study is a randomized comparative intervention study involving 108 patients aged 18-70 years with obstructive uropathy resulting from urolithiasis and requiring decompression of the urinary tract. Patients were further randomly divided into two equal groups, group A was DJ stent and group B was PCN group. The main outcomes were intraoperative and postoperative cumulative complication rates documented with follow-up between 15 days and 3 months.

Results: There was a higher overall complication rate in the DJ stent group as compared with PCN group (36% vs. 16% p = 0.02). The intraoperative complications were misplacement in 10 patients of the DJ stent group as compared to 3 patients of the control group (p = 0.03) and bleeding in 7 patients of the DJ stent group as compared to 2 patients of the control group (p = 0.04). We also noted that postoperative complications like postoperative urinary tract infections (15% vs. 5%, p = 0.03), stent migration (11% vs. 0%, p = 0.01), postoperative haematuria (13% vs. 4%, p = 0.02) in patients with DJ stents were also higher than in patients in PCN group. The PCN group had less number of complications involving infection and dislodging of the tube than the operating group 3% and 11% respectively with p = 0.02.

Conclusions: This work showed that the complication rate of PCN is significantly less than DJ ureteral stenting in patients with obstructive uropathy due to urolithiasis. The long-term results of PCN treatment can be better in terms of patients’ quality of life.

Keywords: Obstructive uropathy, urolithiasis, Double-J ureteral stent, percutaneous nephrostomy, complication rates.