Tubeless percutaneous nephrolithotomy with double-J stent compared with external ureteral catheter to decrease postoperative complications

OBJECTIVE: To compare the efficacy of tubeless percutaneous nephrolithotomy (PCNL) using double-J stent and tubeless PCNL with external ureteral catheter in decreasing post-PCNL complications.

METHODS: This prospective randomized comparative study includes 148 cases with kidney stones. They were operated by either tubeless PCNL with double-J stent (Group 1) or tubeless with ureteric catheter (Group 2). Group 1 consists of 72 cases (54 males and 18 females). Group 2 consists of 76 patients (56 males and 20 females). Both groups were compared from the point of post-PCNL complications without using tissue sealants or tract cauterization. The study was carried out in the Department of Urology, Al-Thawrah Modern General and Ibn-Seena Hospital, Sana'a, Yemen between January 2008 and January 2010.

RESULTS: In Group 1, the post-PCNL complications were leakage of urine in 4 (5.6%), hematuria >48 hours in 6 (8.3%), fever in 2 (2.8%), and the length of hospital stay was 36-48 hours. In Group 2, the post-PCNL complications were leakage of urine in 13 (17.1%), hematuria in 9 (11.8%), 5 (6.6%) has fever, colonic injury in one, and fluid collections in 8 (10.5%). There was significant difference in urine leakage (p=0.028).

CONCLUSION: Tubeless PCNL with double-J stent was the best method to decrease the complications and length of hospital stay.