Abstract:
Aim: To compare the stone clearance rate in ureteric stones after ureterorenoscopy / lithoclast between patients with and without percutaneous nephrostomy. Methods: After the approval from Ethical committee KEMU this randomized clinical trial was conducted at department of Urology (unit I and unit II), Mayo Hospital Lahore. Sample size of one hundred fifty patients (seventy-five patients in each group) was estimated. Group-A contained patients with upper ureteric stones and having percutaneous nephrostomy due to presence of lumber pain resistant to medical treatment, varying degree of hydronephrosis due to obstructed uropathy and acceptance of procedure and underwent ureterorenoscopy with pneumatic lithoclast. Group-B contained patients with upper ureteric stones with presence of lumber pain and varying degree of hydronephrosis without percutaneous nephrostomy and nephrostomy was not performed and underwent ureterorenoscopy. Results: In current study the mean age of all patients was 35.79±13.14 whereas the mean age in group-A as well as Group-B was 33.77±12.57 years and 37.81±13.47 years respectively, the mean age was statistically same in both groups, p-value> 0.05. In current study there were 102(68%) male and 48(32%) female cases, the male to female ratio was 2.15:1. In current study the mean operative time in group-A was 61.72±12.14 minutes and in group-B was 28.87±9.04 minutes with statistically lesser mean operative time in group-B, p-value <0.05. Conclusion: Results of this study showed that stone clearance rate was significantly higher in URS/Lithoclast without PCN when compared with URS/Lithoclast with PCN patients. i.e., 94.7% vs. 80%, p-value=0.007 because hydrostatic pressure and, mucosal edema of the ureter wall are the most important factors in higher stone clearance rate in group B. In our study drainage of collecting system with PCN has reduced the redundancy of ureter proximal to the obstruction and reduced the mucosal edema within the ureter in case of impacted stone and relatively large stone. The operative time was also less for Group-B when compared it with Group-A. Hence, in future URS/Lithoclast alone can be effectively used to treat patients presenting with upper ureteric stones.
Page(s):
1117-1119
DOI:
DOI not available
Published:
Journal: Pakistan Journal of Medical and Health Sciences, Volume: 14, Issue: 4, Year: 2020
Keywords:
hospital stay
,
SWL
,
nephrolithotripsy
,
Percutaneous nephrolithotomy
,
Tubeless