Renal access in PNL under sonographic guidance: Do we really need to insert an open end ureteral catheter in dilated renal systems? A prospective randomized study

  • Bilal Eryildirim | bilaleryildirim@yahoo.com Dr. Lütfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Murat Tuncer Dr. Lütfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Emre Camur Dr. Lütfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Fatih Ustun Dr. Lütfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Fatih Tarhan Dr. Lütfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.
  • Kemal Sarica Dr. Lütfi Kirdar Training and Research Hospital Urology Clinic, Istanbul, Turkey.

Abstract

Purpose: To evaluate the true necessity of open end ureteral catheter insertion in patients with moderate to severe pelvicalyceal system dilation treated with percutaneous nephrolithotomy (PNL) under sonographic guidance. Patients and methods: 50 cases treated with PNL under sonographic guidance in prone position for solitary obstructing renal stones were evaluated. Patients were randomly divided into two groups; Group 1: Patients in whom a open end ureteral catheter was inserted prior to the procedure; Group 2: Patients receiving no catheter before PNL. In addition to the duration of the procedure as a whole and also all relevant stages as well, radiation exposure time, hospitalization period, mean nephrostomy tube duration, mean drop in Hb levels and all intra and postoperative complications have been evaluated. Results: Mean size of the stones was 308.5 ± 133.2 mm2. Mean total duration of the PNL procedure in cases with open end ureteral catheter was significantly longer than the other cases (p < 0.001). Evaluation of the outcomes of the PNL procedures revealed no statistically significant difference between two groups regarding the stone-free rates (86% vs 84%). Additionally, there was no significant difference with respect to the duration of nephrostomy tube, hospitalization period and secondary procedures needed, complication rates as well as the post-operative Hb drop levels in both groups (p = 0.6830). Conclusions: Our results indicate that the placement of an open end ureteral catheter prior to a PNL procedure performed under sonographic access may not be indicated in selected cases presenting with solitary obstructing renal pelvic and/or calyceal stones.

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Published
2017-10-03
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Issue
Section
Original Papers - Stones and Infections
Keywords:
Percutaneous nephrolithotomy, Ureteral catheter, Renal stone, Ultrasonographic access
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How to Cite
Eryildirim, B., Tuncer, M., Camur, E., Ustun, F., Tarhan, F., & Sarica, K. (2017). Renal access in PNL under sonographic guidance: Do we really need to insert an open end ureteral catheter in dilated renal systems? A prospective randomized study. Archivio Italiano Di Urologia E Andrologia, 89(3), 226-231. https://doi.org/10.4081/aiua.2017.3.226

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