Double-J Stenting Versus Percutaneous Nephrostomy; Postoperative Complications in Management of Ureteral Obstruction

Abstract

Background: Ureteral obstruction is a common surgical problem and managed by stent insertion or percutaneous nephrostomy. However, there is still confusion that which procedure is better in terms of the complications. Objective: To compare the efficacy of double J stenting and percutaneous nephrostomy for ureteral obstruction in terms of post-operative complications. Study Design: Randomized Clinical Trial. Settings: Urology Department, Shaikh Zayed Hospital, Rahim Yar Khan-Pakistan. Duration: One years from January through December 2016. Methodology: Male/female patients (aged: 19-63 years) presenting in the OPD of the hospital with ureteral obstruction were registered during study period. Either of the groups i.e. A (double J stenting, n = 55) or B (percutaneous nephrostomy, n = 55) was allotted to the subjects, randomly. The procedures and subsequent complications were addressed as per hospital protocols. Results: Most of the patients i.e., 75 (68.2% of 110) were male whereas age statistics were, as: M = 49.47, SD = 8.2 (range 19-62) years. Ureteral stone(s) was found as the most prevalent cause of ureteral obstruction in group A (49.1%, n = 27) and B (40.0%, n = 22). Hematuria was seen as a common complication: 33.3 (n = 5) and 42.9% (n = 3) in group A and B, respectively. The rate of complications was significantly lower in group B than A [12.7% (n = 7) vs. 27.3% (n = 15), respectively] (p = .04). Conclusion: Percutaneous nephrostomy is a better procedure (in terms of post-operative complications) than double J stenting in management of ureteral obstruction.

Keywords: Ureteral obstruction, Percutaneous nephrostomy, Stents, Postoperative complication.