Derivación urinaria urgente por patología obstructiva intrínseca o extrínseca de la vía urinaria. Stent ureteral versus Nefrostomía percutánea

Abstract

Introduction: Obstruction of the urinary tract is a relatively frequent disease and sometimes requires urgent urinary derivation. The objective of this study was to compare outcomes and complications in patients with upper urinary tract obstruction after urinary derivation with ureteral stent or percutaneous nephrostomy. Material and Methods: A retrospective study was conducted from 1 January 2011 to 31 December 2012 in 134 patients (65 males, 69 females) with a mean age of 61.2 ± 17.4 yrs who came to our emergency department requiring urgent urinary derivation. Data were gathered on the type of urinary derivation, aetiology, length of hospital stay, clinical and analytical results and complications. Results: A ureteral stent was placed in 89 of the 134 patients and percutaneous nephrostomy in the remaining 45. Creatinine levels and age were significantly higher in the percutaneous nephrostomy versus ureteral stent group. No inter-group differences were found in clinical or analytical outcomes. The hospital stay was longer for the percutaneous nephrostomy patients, attributable to their higher mean age, admission creatinine level, and comorbidities. Conclusions: No differences in outcomes or complications were found between ureteral stent and percutaneous nephrostomy placement. Ureteral stents may be preferable in patients with acute tract obstruction and nephrostomy preferable in patients with malignant obstruction or sepsis with altered inflammatory parameters and a greater comorbidity burden.