Comparison of nephrostomy and double‐J stent in the management of percutaneous nephrolithotomy–induced renal pelvis trauma: A prospective randomized controlled trial

Abstract

AbstractObjectiveThis study aimed to compare the efficacy of nephrostomy versus double‐J (DJ) ureteral stent in managing kidney pelvis trauma during percutaneous nephrolithotomy (PCNL) procedures.MethodologyThis prospective parallel‐group clinical trial involved 60 PCNL patients diagnosed with kidney pelvis perforation during PCNL through nephroscopy (inclusion criteria). Exclusion criteria comprised a history of previous renal surgery or prior PCNL. Eligible patients were alternately assigned to either the insertion of a nephrostomy or a ureteral DJ stent.ResultsA total of 31 patients were included in the nephrostomy group, and 29 were in the DJ group. The mean ± SD of operation duration in nephrostomy and DJ groups were 50.8 ± 23.7 and 45.7 ± 19.3 min, respectively (P = .17). Two‐access PCNLs were performed in 13% and 18% of PCNL operations in the nephrostomy and DJ groups, respectively (P = .72). In the nephrostomy group, 5 patients (17%) had urinoma collection around the kidney, compared with 11 (39%) in the DJ group, showing a statistically significant difference between the two groups (P = .036). Post‐operative fever and urinary leakage were observed in 48% and 32% of patients in nephrostomy group versus 44% and 22% of patients in group DJ (P = .76 and P = .39).ConclusionThe findings of this study indicate a higher percentage of urinoma detected one week after the insertion of a ureteral DJ compared with nephrostomy in PCNL patients who experienced renal pelvis injury during the operation.