Presentation Authors: Nuno Morais*, Jose Pedro Pereira, Paulo Mota, Emanuel Dias, João Torres, Agostinho Cordeiro, Sara Anacleto, Carlos Oliveira, Estêvão Lima, Braga, Portugal
Introduction: Ureteral calculi can be associated with urinary drainage blockage, requiring urinary diversion with percutaneous nephrostomy (PCN) or retrograde ureteral stent (RUS). Currently no evidence exists to support the superiority of one method over the other. This study proposes to compare both approaches regarding the probability of spontaneous stone passage (SSP) and its effect on patientâ€™s quality of life (QoL).
Methods: A prospective trial was carried out from July to October of 2017. 50 patients were selected with hydronephrosis secondary to ureteral stones requiring emergent urinary diversion and distributed in 2 groups according to diversion technique: PCN or RUS. The rate of SSP was evaluated with follow-up CT scan and the QoL assessed with questionaires.
Results: A PCN group (18 patients) and a RUS group (32 patients) were set. Stone size was higher in PCN (median 92mm2) than RUS (median 47mm2) (p=,012) Table 1. The rate of SSP was 25% in RUS group and 38,9% in PCN. On the univariable analysis no statistical effect was found however, when adjusted for stone size, location, previous ureteral manipulation and expulsive therapy, PCN showed a significant higher chance of SSP than RUS (OR=6,667) Table 2. Besides, it was found that 30,2% (n=13) of stones had an upward displacement associated with retrograde endoscopy. A significant decrease between pre and post intervention QoL was found with RUS (p
Conclusions: PCN was associated to a higher rate of spontaneous stone passage when adjusted for stone size and location. Moreover, PCN was better tolerated and associated with fewer urinary symptoms when compared with RUS.