Evaluating the efficacy of percutaneous nephrostomy in managing hematuria following antegrade double j ureteral stent placement

Abstract

Purpose: This study aims to evaluate the clinical outcomes of percutaneous nephrostomy in patients who develop hematuria during percutaneous antegrade double j stent placement. Materials and methods: We conducted a multicenter retrospective cross-sectional study, reviewing medical records from January 2016 to June 2024, to identify patients who underwent percutaneous antegrade double j stent placement and developed hematuria. Percutaneous antegrade double j stent and nephrostomy procedures were performed under ultrasound and fluoroscopic guidance. Results: The study included 151 patients with a mean age of 65.9 ± 15.3 years; 46 (30.5%) were female, and 105 (69.5%) were male. Hematuria was observed in 20 (8.9%) of the 225 antegrade double j stent procedures. Hematuria was significantly more common in patients with benign conditions (35%) compared patients with malignant tumors (9.2%) (p=0.003). Postoperative nephrostomy was performed in 118 (52.4%) of the procedures. Among patients who developed hematuria, 11 (55%) received a nephrostomy, compared to 9 (45%) without hematuria, though this difference was not statistically significant (p=0.811). Conclusion: Percutaneous nephrostomy appears to be an effective intervention for managing hematuria in patients undergoing antegrade double j stent placement. However, the study did not find a statistically significant difference in hematuria incidence with nephrostomy placement, indicating the need for further research with larger sample sizes to confirm these findings and optimize postoperative management strategies.