Comparison of Percutaneous Nephrostomy and Ureteral DJ Stent in Patients with Obstructive Pyelonephritis: A Retrospective Cohort Study.

Purpose: Comparing the two different drainage methods of percutaneous nephrostomy (PCN) versus retrograde ureteral double - J (DJ) stent insertion in patients with obstructive pyelonephritis cases.

Material and methods: In this retrospective study, patients with obstructive pyelonephritis secondary to urolithiasis who underwent PCN or DJ insertion were included in the study. Patients were divided into two groups according to drainage method. After exclusion criteria, the study included 105 patients. The groups were compared for intraoperative outcomes, duration of fluoroscopy usage, the time needed for normalization of infection parameters (white blood cells (WBC), C - reactive protein (CRP), procalcitonin), and complications were observed.

Results: From 105 patients, 56 patients were in DJ stent group and 49 patients were in PCN group. According to intraoperative data, operative time and fluoroscopy duration were significantly shorter in the DJ ureteral stent group (P < .001). WBC returned to normal range in mean 3.5 ± 1.3 days in the DJ stent group and 3.2 ± 1.1 days in the PCN group (95% CI: -0.76-0.21, P = .268). There were no statistically significant differences identified for the duration for CRP, PCT and fever to return to normal range between the drainage methods. The complication rates was 51.8% for DJ stent group and, 30.6% in PCN group (P = .028).

Conclusion: Both methods are effective and safe in obstructive pyelonephritis. Despite the higher complication rate in DJ stent group, these complications were minor.