Percutaneous nephrostomy versus retrograde ureteral stent for acute upper urinary tract obstruction with urosepsis

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2021-02, Vol.27 (2), p.323-328
• Main Authors: Xu, Zi-hao, Yang, Yan-hao, Zhou, Shuang, Lv, Jian-lin
• Format: Article
• Language: English
• Subjects: Acute upper urinary tract obstruction; Emergency drainage; Percutaneous nephrostomy; Retrograde ureteral stent; Urosepsis
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2020.11.022

We aimed to compare the efficacy of percutaneous nephrostomy (PCN) versus retrograde ureteric stent (RUS) for acute upper urinary tract obstruction with urosepsis. We performed a random study, comparing PCN to RUS, for the treatment of patients requiring emergency drainage due to acute upper urinary tract obstruction with urosepsis between January 2019 to March 2020. Data collected included patient characteristics, stone material, microbiological characteristics, and laboratory data. Statistical analysis was performed by the student's t-test or Mann-Whitney U test or chi-squared test and Fisher exact test. At first, a total of 75 patients were eligibly assessed for enrollment. Among them, 3 cases were excluded for declining to participate and 7 cases were failed treated with RUS. At last, 35 PCN (53.85%) and 30 RUS (46.15%) patients were analyzed. There were 24 (36.92%) men and 41 (63.08%) women. The median age was 65 years. Emergency decompression was achieved by PCN in 35 (53.85%) patients and by RUS in 30 (46.15%). Urine culture was positive in 32 (49.23%) patients, of which 17 (53.13%) had E. coli. Postoperative C-reactive protein value and normal temperature recovery time in the PCN group were significantly lower than in the RUS group(P