Comparison of Percutaneous Nephrostomy and Ureteral DJ Stent in Patients with Obstructive Pyelonephritis: A Retrospective Cohort Study

Anıl, Hakan; Şener, Nevzat Can; Karamık, Kaan; Erol, İbrahim; Vuruşkan, Ediz; Erçil, Hakan; Gürbüz, Zafer Gökhan

doi:10.1080/08941939.2022.2062496

Cited by 5 publications

(9 citation statements)

References 19 publications

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“…Our comprehensive examination of the available literature identified 821 studies for potential inclusion in this systematic review with a meta-analysis. Eight of these studies were ultimately deemed pertinent to the present investigation and chosen for inclusion in this systematic review with a meta-analysis ( Figure 1 ) [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 displays the attributes of the eight studies included in this systematic review with a meta-analysis [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. All the studies compared the outcomes of patients who underwent PCN versus ureteral stent placement for urgent decompression in patients with severe UTI resulting from obstructive urolithiasis.…”

Section: Resultsmentioning

confidence: 99%

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Percutaneous Nephrostomy versus Ureteral Stent for Severe Urinary Tract Infection with Obstructive Urolithiasis: A Systematic Review and Meta-Analysis

Moon,

Jun,

Jeong

et al. 2024

Medicina

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Background and Objectives: The European Association of Urology guidelines on urolithiasis highlight the limited evidence supporting the superiority of percutaneous nephrostomy (PCN) over retrograde ureteral stent placement for the primary treatment of infected hydronephrosis secondary to urolithiasis. We, therefore, conducted a systematic review and meta-analysis comparing the effects of PCN and retrograde ureteral stent in patients with severe urinary tract infections secondary to obstructive urolithiasis. Materials and Methods: Meta-analyses were performed to compare four outcomes: time for the temperature to return to normal; time for the white blood cell (WBC) count to return to normal; hospital length of stay; and procedure success rate. After a full-text review, eight studies were identified as relevant and included in our systematic review and meta-analysis. Results: No significant difference was detected between PCN and retrograde ureteral stenting for the time for the temperature to return to normal (p = 0.13; mean difference [MD] = −0.74; 95% confidence interval [CI] = −1.69, 0.21; I2 = 96%) or the time for the WBC count to return to normal (p = 0.24; MD = 0.46; 95% CI = −0.30, 1.21; I2 = 85%). There was also no significant difference between methods for hospital length of stay (p = 0.78; MD = 0.45; 95% CI = −2.78, 3.68; I2 = 96%) or procedure success rate (p = 0.76; odds ratio = 0.86; 95% CI = 0.34, 2.20; I2 = 47%). Conclusions: The clinical outcomes related to efficacy did not differ between PCN and retrograde ureteral stenting for severe urinary tract infection with obstructive urolithiasis. Thus, the choice between procedures depends mainly on the urologist’s or patient’s preferences.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Percutaneous Nephrostomy versus Ureteral Stent for Severe Urinary Tract Infection with Obstructive Urolithiasis: A Systematic Review and Meta-Analysis

Moon,

Jun,

Jeong

et al. 2024

Medicina

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“…In a retrospective study [ 25 ], PCN and RUS for drainage of obstructive pyelonephritis secondary to urolithiasis were also compared, but using four outcome measures (intraoperative outcomes, duration of fluoroscopy usage, time for normalization of infection parameters, and complications) different from our analysis; therefore, it will also not be included in our analysis. However, the authors also found both methods equally effective and safe, but with higher minor complication rates (such as hematuria and dysuria) in RUS group.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis

Cardoso,

Coutinho,

Neto

et al. 2024

Asian Journal of Urology

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“…Before urosepsis develops, the timing of when emergency drainage is performed is crucial; most experts agree that emergency drainage should be performed within two days of admission [ 2 , 4 , 8–10 ]. Blackwell et al.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] conducted a retrospective study of 69 patients with acute obstructive pyelonephritis, and they found that PCN and RUSI are both effective surgical decompression methods, and Anıl et al. [ 4 ] came to the same conclusion. However, Mokhmalji et al.…”

Section: Introductionmentioning

confidence: 99%

Emergency decompression for patients with ureteral stones and SIRS: a prospective randomized clinical study

Zhou

et al. 2023

Annals of Medicine

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Objective Patients with ureteral calculi and systemic inflammatory response syndrome (SIRS) often require emergency drainage, and percutaneous nephrostomy (PCN) and retrograde ureteral stent insertion (RUSI) are the most commonly used methods. Our study aimed to identify the best choice (PCN or RUSI) for these patients and to examine the risk factors for progression to urosepsis after decompression. Methods A prospective, randomized clinical study was performed at our hospital from March 2017 to March 2022. Patients with ureteral stones and SIRS were enrolled and randomized to the PCN or RUSI group. Demographic information, clinical features and examination results were collected. Results Patients ( n = 150) with ureteral stones and SIRS were enrolled into our study, with 78 (52%) patients in the PCN group and 72 (48%) patients in the RUSI group. Demographic information was not significantly different between the groups. The final treatment of calculi was significantly different between the two groups ( p < .001). After emergency decompression, urosepsis developed in 28 patients. Patients with urosepsis had a higher procalcitonin ( p = .012) and blood culture positivity rate ( p < .001) and more pyogenic fluids during primary drainage ( p < .001) than patients without urosepsis. Conclusion PCN and RUSI were effective methods of emergency decompression in patients with ureteral stone and SIRS. Patients with pyonephrosis and a higher PCT should be carefully treated to prevent the progression to urosepsis after decompression. Key message In this study, we evaluate the best choice (PCN or RUSI) for patients who have ureteral stones and SIRS and to examine the risk factors for progression to urosepsis after decompression. This study found that PCN and RUSI were effective methods of emergency decompression. Pyonephrosis and higher PCT were risk factors for patients to develop to urosepsis after decompression.

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Comparison of Percutaneous Nephrostomy and Ureteral DJ Stent in Patients with Obstructive Pyelonephritis: A Retrospective Cohort Study

Cited by 5 publications

References 19 publications

Percutaneous Nephrostomy versus Ureteral Stent for Severe Urinary Tract Infection with Obstructive Urolithiasis: A Systematic Review and Meta-Analysis

Percutaneous Nephrostomy versus Ureteral Stent for Severe Urinary Tract Infection with Obstructive Urolithiasis: A Systematic Review and Meta-Analysis

Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis

Emergency decompression for patients with ureteral stones and SIRS: a prospective randomized clinical study

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