Tail stent versus re-entry tube: a randomized comparison after percutaneous stone extraction.
OBJECTIVE
To evaluate the efficacy of a 7F tail stent with an 18F Councill nephrostomy tube and compare it to a 24F re-entry Malecot nephrostomy tube after percutaneous nephrolithotomy.


METHODS
Forty patients were prospectively randomized to receive either a 24F re-entry Malecot nephrostomy tube (group A, n = 20) or a 7F tail stent with an 18F Councill nephrostomy tube (group B, n = 20) for postoperative drainage. Patients were evaluated with an analogue scale questionnaire 15 days after percutaneous nephrolithotomy at the routine office follow-up visit asking them to rate the flank pain on a 0 to 10 scale, urinary urgency on a 0 to 10 scale, and quality of life, while the external drainage tubes were still in place.


RESULTS
The mean length of stay was 4.5 and 3.5 days for groups A and B, respectively. Flank urine leakage was present in all patients in group A for a period of 6 to 12 hours, and no patient in group B had any significant flank drainage. A statistically significant reduction of flank pain in favor of group B was observed (P = 0.0002). We did not observe any statistically significant difference when evaluating the urgency (P = 0.1) and quality-of-life scores (P = 0.09) between the two groups, even though a trend was noted toward amelioration in favor of group B patients.


CONCLUSIONS
The results of the present study suggest that the 7F tail stent is certainly better tolerated by the patients after percutaneous nephrolithotomy compared with the standard 24F re-entry Malecot nephrostomy tube.
Liatsikos
Evangelos N
EN
Department ofEndourology and Laparoscopy, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
Hom
David
D
Dinlenc
Caner Z
CZ
Kapoor
Rakesh
R
Alexianu
Mihai
M
Yohannes
Paulos
P
Smith
Arthur D
AD
D004322:Drainage / Q000295:instrumentation*; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation*; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D011788:Quality of Life; D015607:Stents