Circle nephrostomy tube revisited.

Area of Science:

• Urology
• Medical Devices
• Health Economics

Background:

• Limited options exist for chronic urinary drainage via nephrostomy tubes.
• Circle nephrostomy tubes (CNTs), despite being invented in 1954, are underutilized compared to standard nephrostomy tubes (SNTs).
• CNTs offer potential advantages in indwelling time, requiring semi-annual changes versus SNTs' monthly changes.

Purpose of the Study:

• To compare the indwelling times and costs of CNTs versus SNTs.
• To analyze the frequency of tube changes for both CNTs and SNTs.
• To identify reasons for earlier-than-scheduled tube changes for CNTs.

Main Methods:

• Retrospective review of patients with CNT insertion between 2009 and 2015.
• Tabulation of indications for chronic indwelling nephrostomy tubes.
• Comparison of tube change frequency and analysis of insertion/exchange costs between CNTs and SNTs in the same patients.

Main Results:

• CNTs demonstrated a significantly longer mean interval between changes (168.3 days) compared to SNTs (44.8 days) (p=0.028).
• Tube blockage and urinary leakage were the primary reasons for premature CNT removal.
• Switching to CNTs resulted in an estimated cost saving of $46,861.10 for the cohort.

Conclusions:

• Circle nephrostomy tubes (CNTs) are associated with significantly fewer changes compared to standard nephrostomy tubes (SNTs).
• CNTs offer a more cost-effective solution for patients requiring chronic nephrostomy drainage.
• CNTs are a viable alternative for poor-surgical-risk patients needing long-term urinary drainage.