Double-J stent versus percutaneous nephrostomy for emergency upper urinary tract decompression

Area of Science:

• Urology
• Nephrology
• Medical Imaging

Background:

• Acute obstructive uropathy presents a significant clinical challenge, potentially leading to severe kidney damage.
• Timely urinary diversion is crucial for preserving renal function in obstructive uropathy.

Purpose of the Study:

• To compare the efficacy and safety of percutaneous nephrostomy (PCN) versus retrograde ureteral stenting (RUS) for acute obstructive uropathy.
• To evaluate the success rates and complications associated with each urinary diversion technique.

Main Methods:

• Retrospective analysis of 1500 patients with acute obstructive uropathy treated between January 2017 and December 2021.
• Data collected included patient demographics, anatomical details (via ultrasound, CT, KUB), and treatment outcomes.
• Patients underwent either double-J stenting (a form of RUS) or PCN.

Main Results:

• 1172 patients received double-J stenting, while 328 initially underwent PCN.
• Double-J stenting was successful in the majority of cases.
• Subsequent PCN was required in 54 instances where initial double-J stenting was ineffective.

Conclusions:

• Double-J stenting is an effective primary treatment for urinary drainage in most cases of acute obstructive uropathy.
• Percutaneous nephrostomy serves as a valuable alternative when retrograde ureteral stenting is insufficient.