Choosing the nephrostomy size after percutaneous nephrolithotomy.
OBJECTIVE
To evaluate the effect of nephrostomy tube size on perioperative outcomes of percutaneous nephrolithtotmy (PCNL).


METHODS
Forty-five well-matched patients with normal renal function were prospectively divided in two nonrandomized groups after uneventful PCNL (to receive either a 22-Fr, group 1 (n = 24 pts), or a 12-Fr nephrostomy tube, group 2 (n = 21 pts)). In all a balloon nephrostomy catheter with detachable funnel (Rüsch Teleflex, Germany) was used. A Visual Analogue Scale (VAS) for measuring the pain was administered 8 and 24 h after the procedure. Postoperative analgesics use (Ketoralac Tromethamine 30 mg), pre- and postoperative Hb, renal function and urinary leaks were registered.


RESULTS
Groups were comparable as demographics and stone characteristics. VAS pain score was significantly higher in group 1 (4.25 vs. 3.2, P < 0.001) only 8 h postoperatively. No significant difference was found in the VAS pain score 24 h p.o. Similarly, analgesics use (1.6 vs. 1.1, P = 0.05), sHb (1.42 vs. 1.21, P = 0.055) and hospital stay (3.8 vs. 3.6, P = 0.63) were not significant between the two groups of patients.


CONCLUSIONS
A small bore nephrostomy catheter may reduce pain in the immediate postoperative time. It does not affect blood loss and hospital stay so it can safely be used instead of a large size nephrostomy tube, after uneventful percutaneous procedures.
De Sio
Marco
M
Clinica Urologica, Seconda Università degli Studi, Piazza Miraglia 2, 80138, Naples, Italy. marcdesio@tin.it
Autorino
Riccardo
R
Quattrone
Carmelo
C
Giugliano
Francesco
F
Balsamo
Raffaele
R
D'Armiento
Massimo
M
D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation* / Q000379:methods*; D010147:Pain Measurement; D012189:Retrospective Studies; D016896:Treatment Outcome
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