scholarly journals MP89-07 PERCUTANEOUS NEPHROSTOMY VERSUS RETROGRADE URETERAL STENTING IN PATIENTS WITH OBSTRUCTIVE PYELONEPHRITIS AND SEPSIS: IMPLEMENTATION OF A HOSPITAL-WIDE PROTOCOL

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Elisabeth M. Sebesta ◽  
Stephanie Thompson ◽  
David Mobley ◽  
Ojas Shah
Keyword(s):  
Percutaneous Nephrostomy ◽  
Ureteral Stenting ◽  
Obstructive Pyelonephritis

scholarly journals Long-Term Results after Acute Therapy of Obstructive Pyelonephritis

2015 ◽  
Vol 94 (4) ◽  
pp. 436-441 ◽  
Author(s):  
Winfried Vahlensieck ◽  
Doris Friess ◽  
Werner Fabry ◽  
Raphaela Waidelich ◽  
Thomas Bschleipfer
Keyword(s):  
Percutaneous Nephrostomy ◽  
Long Term Results ◽  
Acute Therapy ◽  
Urinary Drainage ◽  
Long Term Follow Up ◽  
Ureteral Stenting ◽  
Tract Infections ◽  
Obstructive Pyelonephritis

Introduction: To evaluate therapeutic results till 5 years after therapy of obstructive pyelonephritis (OPN) emphasizing regular follow-up. Material and Methods: During 5 years, 57 patients with OPN were treated. The patients' charts were reviewed retrospectively for clinical data. These were completed by a questionnaire. Results: In the group of 57 patients (average age 56 years), about two third were women. Urolithiasis (65%) and tumors (21%) were the main causes of obstruction; fever (91%) and loin pain (86%) the main symptoms. Three fourth of the patients showed renal insufficiency and nearly 50% anemia. E. coli and Proteus spp. were the dominating organisms. Sonography detected obstruction in 93% cases. In one third of cases, CT scan was added; 81% percutaneous nephrostomy and 19% ureteral stenting were the initial methods of urinary drainage. During therapy, 23% nephrectomies (19% complete, 4% partial) were performed. Long-term follow-up showed 11% recurrent OPN and 33% recurrent UTI. Conclusions: After diagnosis of OPN, primary nephrostomy or ureteral stenting and antibiotic therapy are the first measures. If recurrent urinary tract infections or OPN occur, long-term follow-up and low-dose antibiotic prophylaxis may be discussed.

scholarly journals Predictors for Retrograde Ureteral Stenting Failure as an Initial Drainage Method for Emergent Complicated Acute Calculus Obstructive Uropathy

2021 ◽  
Vol 2 (4) ◽  
pp. 229-238
Author(s):  
M.A. Elbaset ◽  
Mohamed Edwan ◽  
Rasha T. Abouelkhei ◽  
Rawdy Ashour ◽  
Mohamed Ramez ◽  
...  
Keyword(s):  
Obstructive Uropathy ◽  
Percutaneous Nephrostomy ◽  
Factors Associated ◽  
Patient Demographics ◽  
Urinary Drainage ◽  
Radiological Data ◽  
Ureteric Orifice ◽  
Ureteral Stenting ◽  
Time Of Admission ◽  
Obstructive Pyelonephritis

Objective: To define predictors for initial retrograde ureteral stenting (RUS) failure with the need for the percutaneous nephrostomy (PCN) insertion as a drainage method in patients with complicated acute calculus obstructive uropathy. Methods: We undertook a retrospective evaluation of patients who presented with complicated obstructive calculus uropathy (acute renal failure or obstructive pyelonephritis) between January 2016 and January 2020. Patients in whom there was failure to visualize ipsilateral ureteric orifice and those with extrinsic ureteral obstruction were excluded. Patient demographics and radiological data including stone site, hydronephrosis grade, maximum transverse stone diameter, periureteral density (PUD) and pericalcular ureteric thickness (P-CUT) at the maximum transverse stone diameter were assessed using non-contrast computed tomography at the time of admission. Results: The study included 256 patients who were managed initially by RUS trial. Of them, 48 (18.8 %) had RUS failure. The presence of acute pyelonephritis, increased maximum transverse stone diameter ≥ 9.5 mm, P-CUT ≥ 7.5 mm, and PUD at stone level ≥ 17.5 HU were risk factors associated with RUS failure (P = 0.007, 0.002, < 0.001, and < 0.001, respectively). Conclusion: Initial radiological stone and ureteric characteristics, in addition to the clinical diagnosis of obstructive pyelonephritis, can be used to determine PCN insertion as the preferred option over RUS for urinary drainage.

scholarly journals Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ismail Zul Khairul Azwadi ◽  
Mohd Noor Norhayati ◽  
Mohd Shafie Abdullah
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Obstructive Uropathy ◽  
Meta Analysis ◽  
Percutaneous Nephrostomy ◽  
Procedural Pain ◽  
Controlled Trials ◽  
Failure Rates ◽  
Ureteral Stenting

AbstractAcute obstructive uropathy is associated with significant morbidity among patients with any condition that leads to urinary tract obstruction. Immediate urinary diversion is necessary to prevent further damage to the kidneys. In many centres, the two main treatment options include percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS). The purpose of this study if to compare the efficacy and safety of PCN and RUS for the treatment of acute obstructive uropathy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, the World Health Organisation International Clinical Trials Registry Platform and ClinicalTrials.gov. We also searched the reference lists of included studies to identify any additional trials. We included randomised controlled trials and controlled clinical trials comparing the outcomes of clinical improvement (septic parameters), hospitalisation duration, quality of life, urinary-related symptoms, failure rates, post-procedural pain [measured using a visual analogue scale (VAS)] and analgesics use. We conducted statistical analyses using random effects models and expressed the results as risk ratio (RR) and risk difference (RD) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CIs). Seven trials were identified that included 667 patients. Meta-analysis of the data revealed no difference in the two methods in improvement of septic parameters, quality of life, failure rates, post-procedural pain (VAS), or analgesics use. Patients receiving PCN had lower rates of haematuria and dysuria post-operatively and longer hospitalisation duration than those receiving RUS. PCN and RUS are effective for the decompression of an obstructed urinary system, with no significant difference in most outcomes. However, PCN is preferable to RUS because of its reduced impact on the patient’s post-operative quality of life due to haematuria and dysuria, although it is associated with slightly longer hospitalisation duration.

scholarly journals Comparison between the use of percutaneous nephrostomy and internal ureteral stenting in the management of long-term ureteral obstructions

2012 ◽  
Vol 23 (3) ◽  
pp. 82-84 ◽  
Author(s):  
Huan-Chin Chang ◽  
Shou-Hung Tang ◽  
Feng-Pin Chuang ◽  
Sheng-Tang Wu ◽  
Guang-Huan Sun ◽  
...  
Keyword(s):  
Percutaneous Nephrostomy ◽  
Ureteral Stenting

Percutaneous nephrostomy and antegrade ureteral stenting: technique—indications—complications

2006 ◽  
Vol 16 (9) ◽  
pp. 2016-2030 ◽  
Author(s):  
Klaus Armin Hausegger ◽  
Horst Rupert Portugaller
Keyword(s):  
Percutaneous Nephrostomy ◽  
Ureteral Stenting

scholarly journals Different Management Options for Transplant Ureteral Obstructions within an Inguinal Hernia

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Felix Cheung ◽  
Merrit Marion Debartolo ◽  
Leonard Michael Copertino ◽  
April Adams Szafran ◽  
Chelsea Caron Estrada ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Case Reports ◽  
Percutaneous Nephrostomy ◽  
Tube Placement ◽  
Rare Entity ◽  
Nephrostomy Tube ◽  
Management Options ◽  
Definitive Repair ◽  
Ureteral Stenting

Ureteral obstruction secondary to an inguinal hernia with transplant ureteral component is an extremely rare entity with only several case reports found in literature. In all previously reported cases, management of the obstruction involved temporary drainage with ureteral stenting or nephrostomy tube placements followed by delayed definitive repair. We present two case reports, here one being the first one managed by immediate definitive repair via ureteral reimplant and herniorrhaphy and a second case by delayed definitive repair after percutaneous nephrostomy tube placement. Both patients continued to do well postoperatively with normalization of renal function on follow-up.

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