Open AccessComparison between the use of percutaneous nephrostomy and internal ureteral stenting in the management of long-term ureteral obstructions
Author(s) -
Huan-Chin Chang,
Shou-Hung Tang,
Feng-Pin Chuang,
ShengTang Wu,
GuangHuan Sun,
DahShyong Yü,
SunYran Chang,
TaiLung Cha
Publication year - 2012
Publication title -
urological science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.155
H-Index - 8
eISSN - 1879-5234
pISSN - 1879-5226
DOI - 10.1016/j.urols.2012.07.008
Subject(s) - medicine , hydronephrosis , percutaneous nephrostomy , stent , surgery , renal function , urology , percutaneous , decompression , creatinine , urinary system
ObjectivesIn this study, we compared between the efficacy and complications of percutaneous nephrostomy (PCN) tubes and those of internal ureteral stents (e.g., double-J stents) used for relieving ureteral obstructions.Materials and methodsA retrospective chart review was performed. Between 2003 and 2009, 110 patients (63 females and 47 males, with a mean age of 63.6 years, range 19–89 years) who had an extrinsic ureteral obstruction, and subsequently underwent either PCN tube placement (n = 44) or internal ureteral stent placement (n = 66), were enrolled. Clinical data on patients with duration of diversion/drainage for more than 6 months were collected. Statistical analyses were performed with respect to a patient's age, etiology of the obstruction, outcome of residual hydronephrosis, and renal function tests.ResultsPatient ages and procedure-related complications were comparable between these two groups. The mean duration of diversion was 16.8 ± 8.6 months in the stent group versus 14.1 ± 6.7 months in the PCN group (p = 0.067). A smaller elevation in serum creatinine was noted in the PCN group (0.21 vs. 0.78 mg/dL, p = 0.03). Nine of 86 (10.4%) double-J stents were converted to PCN tubes during the study period. Residual hydronephrosis after decompression was more common in the stent group than in the PCN group (65.2% vs. 27.2%, p = 0.01). These findings suggest better preservation of renal function by a PCN tube.ConclusionsResults of this study suggest that, to better preserve renal function, PCN is the choice of treatment, irrespective of the etiology. While patients who have a PCN tube may have to carry an additional external drainage device, the complications did not seem to differ significantly from those who used internal drainage with a ureteral stent. Because young cancer patients may especially need aggressive chemotherapy to prolong their survival, PCN urinary drainage may become a better choice from the standpoint of cancer control