title: When routine D-J implantation necessary during PNL?
abstract: OBJECTIVE
  We investigated the characteristics of patients who underwent Double-J catheter (D-J) implantation, the risk factors for prolonged urine leakage (PUL), and prediction of patients who require medical treatment.
  
  
  METHODS
  The data of 535 adult patients who underwent PNL due to kidney stone disease between January 2005 and December 2011 in our clinic were analyzed retrospectively. Patients were divided into 2 groups: Group 1 (n=77) (14.39%) included patients with Double-J catheter due to prolonged (> 24 h) urinary leakage and Group 2 (n=458) (85.61%) patients without urinary leakage.
  
  
  RESULTS
  The mean stone burden was 951.94 ± 539.09 mm2 in Group 1, and 676.35 ±296.65 mm2 in Group 2 (p<0.05). DJ catheter was implanted in 11.33% of the patients with stone burden below 1000 mm2 versus in 51.21% of the patients with stone burden above 1000 mm2. In Group 1, the number of patients with two or more accesses performed was 18.18, whereas in Group 2 it was 8.5% (p<0.05). Among all patients, DJ implantation was performed in 13.07% of patients with a single access versus 26.41% of patients with two or more accesses. Also, DJ catheter was implanted in 41.46%of patients with residual stones versus 12.14% of stone-free patients. Three patients with stone burden above 1000 mm2, two or more accesses, and residual stone, all of them required DJ implantation.
  
  
  CONCLUSIONS
  DJ implantation due to PUL had approximately 5-fold increase stone burden above 1000 mm2, 2-fold increase in patients undergoing two or more access and 3-fold increase in patients with residual stones. Therefore, we think that the D-J implantation is highly advisable in case of a stone load above 1000 mm2, two or more accesses, and in patients with residual stones.
authors.affiliation: Department of Urology. University of Gaziantep. School of Medicine. Gaziantep. Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Bayrak
authors.affiliation: Department of Urology. University of Gaziantep. School of Medicine. Gaziantep. Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Seckiner
authors.affiliation: Department of Urology. University of Gaziantep. School of Medicine. Gaziantep. Turkey.
authors.forename: Sakip M
authors.initials: SM
authors.lastname: Erturhan
authors.affiliation: Department of Urology. University of Gaziantep. School of Medicine. Gaziantep. Turkey.
authors.forename: Ersan
authors.initials: E
authors.lastname: Bulut
authors.affiliation: Department of Urology. University of Gaziantep. School of Medicine. Gaziantep. Turkey.
authors.forename: Asaf
authors.initials: A
authors.lastname: Demirbag
authors.affiliation: Department of Urology. University of Gaziantep. School of Medicine. Gaziantep. Turkey.
authors.forename: Asaf
authors.initials: A
authors.lastname: Erbagci
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization