PD7-10 EXIT STRATEGY FOLLOWING MPNL – PROSPECTIVE RANDOMIZED STUDY.

Abstract

You have accessJournal of UrologyStone Disease: Therapy I1 Apr 2014PD7-10 EXIT STRATEGY FOLLOWING MPNL – PROSPECTIVE RANDOMIZED STUDY. Ravindra Sabnis, Arvind Ganpule, Shashikant Mishra, Jigish Vyas, Raguram Ganeshmoni, Jitendra Jagtap, Amit Bhattu, and Mahesh Desai Ravindra SabnisRavindra Sabnis More articles by this author , Arvind GanpuleArvind Ganpule More articles by this author , Shashikant MishraShashikant Mishra More articles by this author , Jigish VyasJigish Vyas More articles by this author , Raguram GaneshmoniRaguram Ganeshmoni More articles by this author , Jitendra JagtapJitendra Jagtap More articles by this author , Amit BhattuAmit Bhattu More articles by this author , and Mahesh DesaiMahesh Desai More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.699AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Since MPNL involves small size tract, many prefer to do tubeless (no nephrostomy) procedure. However most of them insert double J stent. Some prefer to keep nephrostomy tube & avoid stent. We decided to do a prospective randomized study between 3 groups – no nephrostomy - no DJ stent, No Nephrostomy with DJ stent & Nephrostomy – no DJ stent. Parameters compared were post op pain & analgesic dose requirement, perinephric collection, urine leak, stone clearance. METHODS After HREC approval & those who consented for study, 90 patients who underwent MPNL for stone size bet 1-2.5 cm renal calculi were randomized in 3 groups. Group A – No nephrostomy & no DJ stent. (ureteric catheter & foley cath for 24 hrs) Group B – No nephrostomy with double J stent (foley catheter for 24 hrs), Group C – 14 F nephrostomy. Ureteric cath & foley cath – all removed in 24 hrs. Those who required multiple tracts, had incomplete clearance intra-op, or had intra-op complications like bleeding, perforation were excluded form the study. In Group B - DJ stent was removed after 10 days. Parameters evaluated were – Stone characteristics, post operative visual analogue score, analgesia dose requirements, urinary leak of perinephric collection, fever, stone clearance, fall in hemoglobin & over all hospital stay. RESULTS Mean stone size & location was same in all groups. VAS pain score in Group A was 1.5 – 0.9, In Group B - 1.9 – 0.6 & in Group C - 2.3 – 1.4. (p values; A vs B = 0.014, B vs C= 0.206, A vs C= 0.003). Tramadol requirement was least in Group A as compared to Gr. B & C. Difference was statistically significant. There was no difference in Hb drop, urine leakage, stone free rate. None had any peri-operative complication in the form of fever, perinephric collection…etc. Mean hospital stay in Gr A (1.3 – 0.7days) & in Gr. B ( 1.2-0.6 days) was similar but shorter than Gr. C (2.0 – 1.6, p = 0.025). In Group C, 46.7% patients had significant stent related symptoms affecting quality of life as assessed at 10 days. follow up. None need any auxiliary procedure except stent removal in Gr. B. CONCLUSIONS Following uncomplicated MPNL, no nephrostomy & no DJ as exit strategy is safe. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e187 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Ravindra Sabnis More articles by this author Arvind Ganpule More articles by this author Shashikant Mishra More articles by this author Jigish Vyas More articles by this author Raguram Ganeshmoni More articles by this author Jitendra Jagtap More articles by this author Amit Bhattu More articles by this author Mahesh Desai More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...