PD16-09 EXTERNALIZED URETERAL CATHETER VERSUS DOUBLE J STENTING IN TUBELESS PERCUTANEOUS NEPHROLITHOTOMY: A PROSPECTIVE, RANDOMIZED STUDY.

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy I1 Apr 2017PD16-09 EXTERNALIZED URETERAL CATHETER VERSUS DOUBLE J STENTING IN TUBELESS PERCUTANEOUS NEPHROLITHOTOMY: A PROSPECTIVE, RANDOMIZED STUDY. Gyanprakash Singh, Datteswar Hota, Sabyasachi Panda, Samir Swain, and Pramod Kumar Mohanty Gyanprakash SinghGyanprakash Singh More articles by this author , Datteswar HotaDatteswar Hota More articles by this author , Sabyasachi PandaSabyasachi Panda More articles by this author , Samir SwainSamir Swain More articles by this author , and Pramod Kumar MohantyPramod Kumar Mohanty More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.843AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Since introduction, tubeless PCNL has undergone various technical modifications to further improve the outcome. Several published literature report that use of an externalized ureteral catheter during tubeless PCNL can obviate the stent related discomfort and the need for a second procedure (i.e. cystoscopic removal of stent). We conducted a prospective, randomized study to compare the outcomes using 2 different techniques (externalized ureteric catheter and double J stent) of internal drainage following tubeless PCNL. METHODS From June 2011 to March 2016, a total of 492 patients underwent tubeless PCNL at our institution. A double J stent was placed in all cases of bilateral simultaneous PCNL, residual stone fragments, PCNL in solitary kidney and in patients with renal failure, so were excluded from study (n=55). Rest 437 patients were randomized into 2 groups: Group A (Tubeless PCNL with externalized ureteral catheter n= 225) and Group B (Tubeless PCNL with double J stent n=212). Study parameters include baseline (age, sex, stone burden, stone location/laterality, anomalous kidneys, past history of stone surgery), intraoperative (operating time, number of punctures, supracostal access, blood loss) and postoperative (analgesia requirement, hospital stay, stent related symptoms, complications, cost of treatment) and appropriate statistical methods were used for analysis. RESULTS Baseline characteristics were comparable in both the groups. No statistical significant difference was observed between the groups with regards to operating time, number of punctures, site of puncture (supracostal or infracostal) and blood loss. Analgesia requirement (P= 0.04), hospital stay (P= 0.02), stent related symptoms (P=0.001) and treatment cost (P=0. 005) were significantly less in group A. CONCLUSIONS Our study demonstrated that tubeless PCNL using a ureteric catheter is a safe, reliable and relatively cost effective technique. It can reduce the complications associated with double J stent without affecting the efficacy of the procedure. However, the surgeon must ensure complete stone clearance in order to avoid ureteric colic. Further prospective, randomized trials are required to substantiate our results. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e351 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Gyanprakash Singh More articles by this author Datteswar Hota More articles by this author Sabyasachi Panda More articles by this author Samir Swain More articles by this author Pramod Kumar Mohanty More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...