Obstructive uropathy treatment complication rate after percutaneous nephrostomy versus double J catheter insertion

Abstract EN

Objectives: To compare between the retrograde double j catheterization and the percutaneous nephrostomy tube insertion as an acute management of obstructive uropathy and to demonstrate which procedure carries the least complications.

Methods: This retrospective study was conducted in Prince Hussein Urology Institute.

(270) patients who underwent these procedures between (May-2016 and Septemper-2017) were included, with the exclusion of severe coagulopathy, post dialysis, distal outflow obstructive uropathy patients, pediatric age groups and pregnant ladies.

According to the type of the procedure, the patients, medical records were divided into two groups: group 1 (150) patients with a retrograde double j catheter insertion, group 2 (120) patients post percutaneous nephrostomy tube insertion, the follow up period was from (postoperative day 1 till definitive management), the age group range, mean age and SD were (between 22 and 64 years), (45.35), (11.03), respectively.

Results: Post double j catheterization, the complications were: urgency and frequency 42% (63 patients), urine leakage 9% (14 patients), dislocation 3% (5 patients), haematuria 37% (56 patients), urosepsis 20% (30 patients), catheter calcification 16% (24) and failure to insert 14% (21patients).

Whereas, post nephrostomy complications were: septicemia 5% (6 patients), bleeding 11% (13 patients), kinked tube 2% (3 patients), incorrect position 4% (5 patients) and failure of insertion 5% (6 patients).

Conclusion: Percutaneous nephrostomy as an initial draining procedure in acute management of upper urinary tract obstruction is superior to double j catheterization before definitive surgery.