Endourology & Stone Disease(구연) (E-168)

Clinical comparison between emergent ureteral stenting vs percutaneous nephrostomy for obstructive urolithiasis patients with fever
울산대학교 의과대학 강릉아산병원 비뇨의학과교실
채한규, 김동수, 박민욱, 안동현, 남욱, 김성진, 김한권, 박종연
Introduction:

Emergent collecting system decompression is considered as a standard treatment in cases of fever or sepsis in patients with obstructive urolithiasis. In general, percutaneous nephrostomy (PCN) is preferred over ureteral stenting when symptoms of stone induced urinary tract infection are more severe or obstruction is severe due to a large stone burden. However, PCN is more invasive than ureteral stenting, and difficult to manage after the procedure, such as maintaining a urine bag. In this study, we investigated whether there are differences in fever improvement according to two different procedures, ureteral stenting and PCN, in patients with urolithiasis with fever.

Materials and methods:

From June 2009 to November 2019, 160 patients who were hospitalized for treatment of urolithiasis were analyzed. Among them, patients who did not have fever (n=62), patients who did not undergo emergency decompression (n=20), and patients who did not have accurate information on medical records (n=7) were excluded. Based on this, 44 patients with emergent ureteral stenting and 27 patients with PCN were retrospectively analyzed the time required to recover fever.

Results:

There were no significant differences in age, gender, BMI, diabetes, stone size and location in each group of patients. There was no significant difference in the choice of initial antibiotic use in each group (p=0.178). In the ureteral stenting group, fever recovered to normal values in 1-2 days in 70.5% of patients, and in the PCN group, fever improved to normal values in 1-2 days in 74% of patients. It was confirmed that there was no significant difference (p=0.733).

Conclusion:

Among the methods of emergent decompression in urinary tract stones patients with fever, ureteral stenting can improve fever as fast as PCN. Therefore, if a patient with fever due to urolithiasis visits the emergency room, we should consider ureteral stenting rather than deciding PCN.
keywords : urolithiasis, ureteral stenting, fever

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