You have accessJournal of UrologyStone Disease: Surgical Therapy III1 Apr 2015MP30-09 URETERIC STENT VERSUS PERCUTANEOUS NEPHROSTOMY FOR ACUTE URETERAL OBSTRUCTION - CLINICAL OUTCOME AND QUALITY OF LIFE: A BI-CENTER PROSPECTIVE STUDY Tomer Erlich, Ohad Shoshany, Shay Golan, Pinhas Livne, David Lifshitz, Barak Rosenzweig, Alon Eisner, Nir Kleinman, Yoram Mor, Jacob Ramon, and Harry Winkler Tomer ErlichTomer Erlich More articles by this author , Ohad ShoshanyOhad Shoshany More articles by this author , Shay GolanShay Golan More articles by this author , Pinhas LivnePinhas Livne More articles by this author , David LifshitzDavid Lifshitz More articles by this author , Barak RosenzweigBarak Rosenzweig More articles by this author , Alon EisnerAlon Eisner More articles by this author , Nir KleinmanNir Kleinman More articles by this author , Yoram MorYoram Mor More articles by this author , Jacob RamonJacob Ramon More articles by this author , and Harry WinklerHarry Winkler More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.591AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal drainage is often indicated for acute ureteral obstruction associated with infection, acute renal failure or intractable pain. Few studies have compared antegrade and retrograde renal drainage. The present study aims to compare the clinical outcome and quality of life following both methods of renal drainage. METHODS In a two-arm bi-center prospective study, ureteral stent was used in one medical center (Group A, n=45), whereas percutaneous nephrostomy was used in a second medical center (Group B, n=30). Only candidates suitable for both techniques were included. Clinical parameters including time interval elapsed until temperature and serum creatinine decline were assessed. Each patient answered 3 dedicated questionnaires, after drainage procedure (“time0”) and at admission for definitive treatment (“time1”): EuroQol 5-D questionnaire, post-drainage symptoms questionnaire and general health assessment. RESULTS Patients' demographics and stone characteristics were similar in both groups. There were 16 (53%) and 15 (33%) febrile patients in groups A and B, respectively. Patients in group A had higher median estimated GFR at presentation (58 vs. 41 ml/1.73m2/min, p=0.011), shorter time to serum creatinine recovery to baseline levels (1 vs. 2 days, p=0.005) but longer time to definitive treatment (47 vs. 20 days, p<0.001). Post-drainage pain, time required for defervescence and the overall complication rate were similar between the groups. The post-drainage symptoms questionnaire demonstrated worse ‘urinary discomfort’ complaints in group A compared to group B at both points of time (p<0.0001 and p=0.034, respectively). Patients in group B suffered more from discomfort with ‘mobility’ and ‘personal hygiene’ at ‘time0’ (p=0.002 and p=0.014, respectively), and this difference has disappeared at ‘time 1’. EQ-5D score was significantly higher (worse) in group B patients concerning ‘self-care’ and ‘daily activity’ domains at ‘time0’ (p=0.002), decreasing to similar score at ‘time1’. General health assessment was similar at ‘time 0’ (70±23 and 69±20) and became higher in group B at ‘time1’ (70±24 and 83±12, p=0.02). CONCLUSIONS No significant clinical difference was found in the outcomes and morbidity indices, in a prospective comparison between retrograde and antegrade drainage approaches. The two techniques had a significantly different impact on quality of life. However, post-drainage symptoms improved with time only in patients treated with percutaneous nephrostomy © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e350 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tomer Erlich More articles by this author Ohad Shoshany More articles by this author Shay Golan More articles by this author Pinhas Livne More articles by this author David Lifshitz More articles by this author Barak Rosenzweig More articles by this author Alon Eisner More articles by this author Nir Kleinman More articles by this author Yoram Mor More articles by this author Jacob Ramon More articles by this author Harry Winkler More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...