title: Choosing the nephrostomy size after percutaneous nephrolithotomy.
abstract: 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.
authors.affiliation: Clinica Urologica, Seconda Università degli Studi, Piazza Miraglia 2, 80138, Naples, Italy. marcdesio@tin.it
authors.forename: Marco
authors.initials: M
authors.lastname: De Sio
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
authors.forename: Carmelo
authors.initials: C
authors.lastname: Quattrone
authors.forename: Francesco
authors.initials: F
authors.lastname: Giugliano
authors.forename: Raffaele
authors.initials: R
authors.lastname: Balsamo
authors.forename: Massimo
authors.initials: M
authors.lastname: D'Armiento
mesh_terms: 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
references.citation: J Urol. 2008 Aug;180(2):612-4
references.pmid: 18554657
references.citation: J Endourol. 2008 Jul;22(7):1433-9
references.pmid: 18690809
references.citation: J Endourol. 2001 Sep;15(7):711-3
references.pmid: 11697402
references.citation: J Urol. 1997 May;157(5):1578-82
references.pmid: 9112480
references.citation: J Endourol. 2004 Oct;18(8):743-7
references.pmid: 15659895
references.citation: J Urol. 2004 Aug;172(2):565-7
references.pmid: 15247731
references.citation: J Endourol. 2000 Nov;14(9):735-7; discussion 737-8
references.pmid: 11110567
references.citation: J Endourol. 2003 Aug;17(6):411-4
references.pmid: 12965069
references.citation: Eur Urol. 2005 Jan;47(1):22-8
references.pmid: 15582245