Ureteral stent versus percutaneous nephrostomy for diversion of stone-induced hydronephrosis

ABSTRACT

Urinary diversion of the obstructed hydronephrosis kidney is indicated by symptoms, such as persistent renal colic, febrile UTI [urosepsis], and uraemia. This study is an attempt to evaluate [PCN] versus ureteral stent in cases of stone-induced hydronephrosis regarding relief of symptoms and quality of life. A total of 40 patients with stone-induced hydronephrosis were randomized into either [PCN] or stent insertion groups. These patients were then evaluated regarding to [a]- the procedure [use of analgesics, x-ray exposure, success of insertion], [b]- relief of accompanying symptoms [duration of diversion, intravenous administration of antibiotics for high temperature]; and [c]- the quality of life. Two groups of patients [a] - the group of [PCN] has an average age of 55 years, and a male-to-female ratio of 128. [b]- The group of ureteral stent has an average age of 49 years, and a male-to-female ratio of 911. - [PCN] was successfully completed in 100% of patients and stents were successful in 80%, with a 20% conversion to [secondary PCN].- The x-ray exposure was shorter in the [PCN] group [p = 0. 052].- Administration of analgesics was more frequent in the stent group [p = 0. 061]. - [PCN] indwelling time was shorter [50% less than 2 weeks] than that of stents [25% less than 2 weeks] [p = 0.043]. - Antibiotics were administered for greater than 6 days in 0% of patients who underwent [PCN] versus 70% in those with stents [p = 0.174]. - Reduction in quality of life was moderate but more pronounced in patients with stents compared to those who underwent [PCN], and was more distinct in males and younger patients. The quality of life progressively improved in the course of diversion with [PCN] but deteriorated with stents. Our results demonstrated that [PCN] is superior to ureteral stents when diversion is indicated in cases of stone-induced hydronephrosis, especially in patients with a high temperature, as well as in males