Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis
Objective: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requiring urgent drainage, by evaluating outcomes regarding urinary symptoms, quality of li...
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| Language: | English |
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Elsevier
2024-04-01
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| Series: | Asian Journal of Urology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388223001431 |
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| author | Andreia Cardoso Aparício Coutinho Gonçalo Neto Sara Anacleto Catarina Laranjo Tinoco Nuno Morais Mário Cerqueira-Alves Estevão Lima Paulo Mota |
| author_facet | Andreia Cardoso Aparício Coutinho Gonçalo Neto Sara Anacleto Catarina Laranjo Tinoco Nuno Morais Mário Cerqueira-Alves Estevão Lima Paulo Mota |
| author_sort | Andreia Cardoso |
| collection | DOAJ |
| description | Objective: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requiring urgent drainage, by evaluating outcomes regarding urinary symptoms, quality of life (QoL), spontaneous stone passage, and length of hospital stays, since there is no literature stating the superiority of one modality over the other. Methods: We searched MEDLINE and other sources for relevant articles in June 2019 without any date restrictions or filters applied. The selection was done first by the title and abstract screening and then by full-text assessment for eligibility. Only randomized controlled trials or cohort studies in patients with hydronephrosis secondary to obstructive urolithiasis that presented comparative data between PCN and RUS placement concerning at least one of the defined outcome measures were included. Lastly, MEDLINE database and PubMed platform were screened again using the same terms, from June 2019 until November 2022. Results: Of 556 initial articles, seven were included in this review. Most works were considered of moderate-to-high quality. Three studies regarding QoL showed a tendency against stenting, even though only one demonstrated statistically significant negative impact on overall health state. Two works reported significantly more post-intervention urinary symptoms in stenting patients. One article found that PCN is a significant predictor of spontaneous stone passage, when adjusted for stone size and location. Findings on length of hospital stays were not consistent among articles. Conclusion: PCN appears to be the intervention better tolerated, with less impact on the patient’s perceived QoL and less post-operative urinary symptoms, in comparison with RUS. Nevertheless, further studies with larger samples and a randomized controlled design are suggested. |
| format | Article |
| id | doaj-art-19b954d5bbb344db826a42effcb7e7ab |
| institution | DOAJ |
| issn | 2214-3882 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-19b954d5bbb344db826a42effcb7e7ab2025-08-20T03:17:35ZengElsevierAsian Journal of Urology2214-38822024-04-0111226127010.1016/j.ajur.2023.03.007Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysisAndreia Cardoso0Aparício Coutinho1Gonçalo Neto2Sara Anacleto3Catarina Laranjo Tinoco4Nuno Morais5Mário Cerqueira-Alves6Estevão Lima7Paulo Mota8Department of Urology, Hospital de Braga, Braga, Portugal; Corresponding author.School of Medicine, University of Minho, Braga, PortugalSchool of Medicine, University of Minho, Braga, PortugalDepartment of Urology, Hospital de Braga, Braga, PortugalDepartment of Urology, Hospital de Braga, Braga, PortugalDepartment of Urology, Hospital de Braga, Braga, PortugalDepartment of Urology, Hospital de Braga, Braga, PortugalSchool of Medicine, University of Minho, Braga, Portugal; Association (2CA-Braga). School of Medicine, University of Minho, Braga, PortugalDepartment of Urology, Hospital de Braga, Braga, Portugal; School of Medicine, University of Minho, Braga, Portugal; Association (2CA-Braga). School of Medicine, University of Minho, Braga, PortugalObjective: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requiring urgent drainage, by evaluating outcomes regarding urinary symptoms, quality of life (QoL), spontaneous stone passage, and length of hospital stays, since there is no literature stating the superiority of one modality over the other. Methods: We searched MEDLINE and other sources for relevant articles in June 2019 without any date restrictions or filters applied. The selection was done first by the title and abstract screening and then by full-text assessment for eligibility. Only randomized controlled trials or cohort studies in patients with hydronephrosis secondary to obstructive urolithiasis that presented comparative data between PCN and RUS placement concerning at least one of the defined outcome measures were included. Lastly, MEDLINE database and PubMed platform were screened again using the same terms, from June 2019 until November 2022. Results: Of 556 initial articles, seven were included in this review. Most works were considered of moderate-to-high quality. Three studies regarding QoL showed a tendency against stenting, even though only one demonstrated statistically significant negative impact on overall health state. Two works reported significantly more post-intervention urinary symptoms in stenting patients. One article found that PCN is a significant predictor of spontaneous stone passage, when adjusted for stone size and location. Findings on length of hospital stays were not consistent among articles. Conclusion: PCN appears to be the intervention better tolerated, with less impact on the patient’s perceived QoL and less post-operative urinary symptoms, in comparison with RUS. Nevertheless, further studies with larger samples and a randomized controlled design are suggested.http://www.sciencedirect.com/science/article/pii/S2214388223001431Ureteral stentPercutaneous nephrostomyObstructive urolithiasisUrinary symptomsQuality of life |
| spellingShingle | Andreia Cardoso Aparício Coutinho Gonçalo Neto Sara Anacleto Catarina Laranjo Tinoco Nuno Morais Mário Cerqueira-Alves Estevão Lima Paulo Mota Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis Asian Journal of Urology Ureteral stent Percutaneous nephrostomy Obstructive urolithiasis Urinary symptoms Quality of life |
| title | Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis |
| title_full | Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis |
| title_fullStr | Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis |
| title_full_unstemmed | Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis |
| title_short | Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis |
| title_sort | percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis a systematic review and meta analysis |
| topic | Ureteral stent Percutaneous nephrostomy Obstructive urolithiasis Urinary symptoms Quality of life |
| url | http://www.sciencedirect.com/science/article/pii/S2214388223001431 |
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