Percutaneous Nephrostomy Versus Ureteral Stents for Diversion of Hydronephrosis Caused by Stones: A Prospective, Randomized Clinical Trial

MOKHMALJI, HASSAN; Braun, P.; Portillo, F. J. Martínez; Siegsmund, M.; Alken, P.; K??HRMANN, KAI UWE

doi:10.1097/00005392-200104000-00007

Cited by 36 publications

(61 citation statements)

References 11 publications

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“…This is similar to the study done by Mokhmalji et al in which the patients who underwent ureteric stenting had a 9:11 male to female ratio and the patients who underwent Percutaneous nephrostomy had a 12:8 male to female ratio. 3 The sex ratio is also similar to the study conducted by Abdul Ghaffar et al which showed a 1.4:1 male to female ratio. 4 The mean age of patients included in Group A (PCN group) in our study was 45.5±15.83 years and in Group B (DJ Stenting Group) was 50.4±14.45 years.…”

Section: Resultssupporting

confidence: 89%

“…Mokhmalji et al showed a success rate of 100% in PCN group but only 80% rate was achieved in the DJS group. 3 Yagci et al also show a 10,11 Total Leukocyte count was normal in 44% of the patients in our study and raised in 56%. Out of these 32% patients underwent percutaneous nephrostomy and 16% underwent ureteric stenting.…”

Section: Resultssupporting

confidence: 69%

“…Although suggestive, but this finding was not significant owing to the longer use of antibiotics in patients with a higher leukocyte count and presence of WBC in urine thus was evident in those patients with fever, urinary tract infection and urosepsis. 3 Post operatively a strict urine output charting was done in all the patients on POD 1, POD 3, POD 5, POD 7, POD 9, POD 11, POD 13, POD 15. The urine output levels included the urine in the drainage bag as well as the nephrostomy bag.…”

Section: Resultsmentioning

confidence: 99%

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Percutaneous nephrostomy or double J stenting, which is better modality for obstructive uropathy-a descriptive study

2016

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Section: Resultssupporting

confidence: 89%

Section: Resultssupporting

confidence: 69%

Section: Resultsmentioning

confidence: 99%

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Percutaneous nephrostomy or double J stenting, which is better modality for obstructive uropathy-a descriptive study

2016

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“…The effectiveness of percutaneous nephrostomy should be given preference over ureteral stents in case initial signs of infected hydronephrosis are detected (16).…”

Section: Commentsmentioning

confidence: 99%

Ultrasound guided percutaneous nephrostomy for obstructive uropathy in benign and malignant diseases

Sood

Jindal

et al. 2006

Int. braz j urol.

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Objective: Analyze the success rate, complications and overall benefit of ultrasound guided percutaneous nephrostomy (PCN) for the relief of obstructive uropathy in benign and malignant diseases. Materials and Methods: PCN was performed in 50 kidneys of 32 patients. It was performed in emergency rooms totally under ultrasound guidance by general surgeons. Seldinger technique was used in all cases. Changes in renal function after the procedure were analyzed using paired t-test. Results: The procedure was successfully completed in 42 out of 50 kidneys (84%). There has been no major complication and 28% minor complications. The renal function improved significantly when PCN was performed for benign conditions (mean creatinine 3.52 mg/dL before and 2.18 mg/dL after PCN), however in malignancy there has been no significant improvement in renal function (before PCN mean creatinine 6.39 mg/dL and after PCN 5.41 mg/dL). Conclusion: We conclude that PCN can be effectively performed under ultrasound guidance and should be the initial procedure in acutely obstructed kidneys with pyonephrosis and poor renal function. In malignant cases, however, improvement in renal function is possible only if the procedure is carried out at an early stage.

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“…There has been some concerns that ureteral stent insertion could increase the risk of exacerbating urinary infection by stone manipulation and that it would be less effective for draining urine as compared with a large-caliber PCN tube [19]. However, previous studies have shown that either PCN or a ureteral stent could effectively relieve obstruction and infection associated with urinary stone [20,21]. Recently, Wang et al reported that, as compared with the insertion of a PCN tube, URS together with a course of strong antibiotics could also be an effective and safe management protocol for fighting sepsis associated with obstructing ureteral stone [22].…”

Section: Discussionmentioning

confidence: 99%

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

Lee

Yoon

et al. 2017

Urogenit Tract Infect

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Purpose: To identify and evaluate the risk factors for the development of recurrent febrile urinary tract infection (fUTI) among patients with previous urinary stone and acute obstructive pyelonephritis (OPN). Materials and Methods:We retrospectively reviewed the medical records of 52 patients, who had urinary tract stones presented with OPN, between 2010 and 2015. Following their initial treatment, patients who were subsequently admitted with fUTI were included. Results: The mean age of patients was 62.2±14.6 years, and the mean follow-up duration was 26.0±20.39 months. Escherichia coli was found to be the dominating organism (68.2%, 15/22) in the initial urine culture. Patients were divided into two groups: The recurrent fUTI group (n=23) and the non-recurrent fUTI group (n=29). Between these two groups, significant differences were found with respect to diabetes history (recurrent group: 47.8% vs. non-recurrent group; 17.2%, p=0.018), stone location (kidney, 60.9% vs. ureter, 31.0%, p=0.031), and initially positive urine culture (60.9% vs. 27.6%, p=0.016). In a multivariate analysis, having an initially positive urine culture (95% confidence interval, 1.130-224.117; p=0.040) was identified as being an independent risk factor for developing recurrent fUTI. In a multivariate analysis, the initial laboratory test finding of acute renal insufficiency (ARI, p=0.019) and presence of a kidney stone (p=0.022) were significant factors associated with a newly-diagnosed-positive urine culture diagnosis. Conclusions: Having an initially positive urine culture was a significant risk factor for the development of recurrent fUTI in urinary stone patients with acute OPN. In addition, repeated urine tests were also needed in patients with ARI or renal stones during the follow-up period.

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Percutaneous Nephrostomy Versus Ureteral Stents for Diversion of Hydronephrosis Caused by Stones: A Prospective, Randomized Clinical Trial

Abstract: Our results demonstrated that percutaneous nephrostomy is superior to ureteral stents for diversion of hydronephrosis caused by stones, especially in patients with a high temperature, as well as in males and juveniles.

Cited by 36 publications

References 11 publications

Percutaneous nephrostomy or double J stenting, which is better modality for obstructive uropathy-a descriptive study

Percutaneous nephrostomy or double J stenting, which is better modality for obstructive uropathy-a descriptive study

Ultrasound guided percutaneous nephrostomy for obstructive uropathy in benign and malignant diseases

The Risk Factors of Recurrent Febrile Urinary Tract Infection within 1 Year in Urinary Stone Patients with Acute Obstructive Pyelonephritis

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