📃 Paper Title: Percutaneous nephrostomy versus ureteral stents for diversion of hydronephrosis caused by stones: a prospective, randomized clinical trial
🧍 Author: H Mokhmalji
🕒 Year: 2001
📚 Journal: The Journal of Urology
🌎 Country: Germany
ㅤContext to the study:
Can you cite a clinical trial which found percutaneous nephrostomy to be the better treatment option for management of obstructive ureteric stones?
ㅤ✅ Take-home message of study:
Nephrostomy insertion is better than ureteric stent insertion for patients presenting ureteric stones and hydronephrosis.
Nephrostomy insertion was more successful, and better tolerated with reduced rate of postoperative infection as well as shorter duration of treatment, as compared with stents.
ㅤ Single-centre, randomised trial
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Study participants:
**Inclusion: **
Single-centre
Ureteric stone with hydronephrosis
40 participants were randomly assigned to either group (20 in the Ureteral stent group; 20 in the percutaneous nephrostomy group).
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Key study outcomes:
Percutaneous nephrostomy was successfully completed in 100% of patients, while stents were successful in 80%. Administration of analgesics was more frequent in the stent group (p = 0.061).
Antibiotics were administered for greater than 5 days in 0% of patients who underwent percutaneous nephrostomy versus 64% in those with stents (p = 0.174).
Indwelling time for ureteral stent was on average longer than nephrostomy (p=0.043). It was greater than 4 weeks in 56.3% in case of stent while only 20% in case of nephrostomy.
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Study Limitations:
Outdated paper and modern-day guidelines are not in keeping with the methodology or outcomes.
The study was not powered appropriately with a small sample size, limited to a single-center and therefore conclusions lack ample validity.
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