Abstract
BackgroundTo compare quality of life (QoL) indices between ureteral stent (DJS) and nephrostomy tube (PCN) inserted in the setting of acute ureteral obstruction.MethodsProspective bi-centered study. Over the span of 2 years, 45 DJS and 30 PCN patients were recruited. Quality of life was assessed by 2 questionnaires, EuroQol EQ-5D and ‘Tube symptoms’ questionnaire, at 2 time points (at discharge after drainage and before definitive treatment).ResultsPatients’ demographics and pre-drainage data were similar. There were no clinically significant differences in patient’s recovery between the groups, including post procedural pain, defeverence, returning to baseline renal function, and septic shock complications.More DJS patients presented to the emergency room with complaints related to their procedure compared to PCN patients. At first, DJS patients complained more of urinary discomfort while PCN patients had worse symptoms relating to mobility and personal hygiene, with both groups achieving similar overall QoL score. At second time point, PCN patients’ symptoms ameliorated while symptoms in the DJS group remained similar, translating to higher overall QoL score in the PCN group.ConclusionsThe two techniques had a distinct and significantly different impact on quality of life. Over time, PCN patients’ symptoms relieve and their QoL improve, while DJS patients’ symptoms persist. Specific tube related symptoms, and their dynamics over time, should be a major determinant in choosing the appropriate drainage method, especially when definitive treatment is not imminent.
Highlights
To compare quality of life (QoL) indices between ureteral stent (DJS) and nephrostomy tube (PCN) inserted in the setting of acute ureteral obstruction
Patients presenting with acute renal failure amounted to 57.8% in the double J stent (DJS) group and 60% in the percutaneous nephrostomy tube (PCN) group
More DJS patients presented to the emergency room with complaints related to their procedure compared to PCN patients (20% vs. 3.7% respectively, p = 0.056), mostly complaining of flank pain and dysuria
Summary
To compare quality of life (QoL) indices between ureteral stent (DJS) and nephrostomy tube (PCN) inserted in the setting of acute ureteral obstruction. The decision which drainage method, when indicated, should be used in a patient presenting with an obstructing ureteral stone is significantly influenced by the clinician’s and patient’s perception of the risks, complexity and Shoshany et al BMC Urology (2019) 19:79 and compared patients’ perception of the two drainage methods while awaiting definitive stone treatment. The results of these studies are not conclusive regarding the gross impact of each drainage method on the patient’s QoL. In the setting of malignant obstruction, similar QoL was achieved in both PCN and DJS groups [6]
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