DRAINING ACUTE OBSTRUCTIVE UROPATHY: NEPHROSTOMY OR STENTING?!

There is always a question: using percutaneous nephrostomy or ureteral stenting? There are a number of international studies that show no reliable difference between them. According to the European Urology guideline, both are equally effective. We were interested in comparing these two methods of drainage in the reality of Georgia.

The present comparison is presented in the form of a retrospective study model and represents only an analysis of the facts. The comparison is presented on 10 10 patients. Patients with acute obstruction (24-48-hour anamnesis) were selected as the selection criteria. Leukocyte initial >11.0* 10⁹/L, Age 22-55, Gender male+female, No other catheter (of any type) of the urinary system is mentioned.  It does not represent a complication of medical intervention. There are no uro-oncological diseases.

Comparison criteria taken as: Length of delay in the clinic stoma is better 25%, Normalization of leukocytosis median 0.5% better in the stoma. The dynamics of the CRP median 41% better in the stoma. Dynamics of creatinine median 30% better in stoma, presence of urethral catheter in stoma 0% in stent 100 %, Elimination of dilatation in stoma 3% is better, P.O. painkillers in stoma 30% in stent 100 %, general anesthesia, in stoma 0% in stent 100 % P.O. Dysuria in stoma 0% in stent 100 %. In a total of 136 nephrostomy patients, the incidence of reoperation was 3 -2%. In a total of 144 patients after ureteral stenting, the incidence of reoperation. In a total of 136 nephrostomy patients, hematuria was 0 - 0%. A total of 144 cases of hematuria after ureteral stenting was 121 - 84%. In total, in 54 nephrostomy patients who were transferred to lithotripsy treatment, removal of stones, elimination of obstruction and nephrostomy decannulation without additional intervention were observed in 48 patients, 96%. In 71 patients after stenting of the ureter, who were referred to lithotripsy treatment, removal of stones, elimination of obstruction and decanulation without additional intervention were observed in 55 patients - 77%. According to the analysis of statistics and facts, the only where the dominance of the stent is visible is the experience of relatives, while other factors indicated the absolute dominance of nephrostoma.