Emergency upper urinary tract decompression: double-J stent or nephrostomy? A European YAU/ESUT/EULIS/BSIR survey among urologists and radiologists

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Pietropaolo A., Seoane L. M., Abadia A. A., Geraghty R., Kallidonis P., Tailly T., ...Daha Fazla

WORLD JOURNAL OF UROLOGY, cilt.40, sa.7, ss.1629-1636, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 40 Sayı: 7
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s00345-022-03979-4
  • Dergi Adı: WORLD JOURNAL OF UROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, EMBASE, Gender Studies Database, MEDLINE
  • Sayfa Sayıları: ss.1629-1636
  • Anahtar Kelimeler: Pelvicalyceal obstruction, Decompression, Double-J stent, Percutaneous nephrostomy, Urologist, Radiologist, URETERAL STONE IMPACTION, PERCUTANEOUS NEPHROSTOMY, URETEROSCOPIC MANAGEMENT, HYDRONEPHROSIS, SEPSIS, OBSTRUCTION, DRAINAGE, OUTCOMES, CALCULI, NEPHROLITHOTOMY
  • Marmara Üniversitesi Adresli: Evet

Özet

Purpose To evaluate the decompression of the pelvicalyceal system between urologists and radiologists. Methods A survey was distributed to urologists and to radiologists comparing double-J stent (DJS), percutaneous nephrostomy (PN) and primary ureteroscopy (URS) for three clinical scenarios (1-febrile hydronephrosis; 2-obstruction and persistent pain; 3-obstruction and anuria) before and after reading literature The survey included perception on radiation dose, cost and quality of life (QoL). Results Response rate was 40% (366/915). 93% of radiologists believe that DJS offers a better QOL compared to 70.6% of urologists (p = 0.006). 28.4% of urologists consider PN to be more expensive compared to 8.9% of radiologists (p = 0.006). 75% of radiologists believe that radiation exposure is higher with DJS as opposed to 33.9% of urologists. There was not a difference in the decompression preference in the first scenario. After reading the literature, 28.6% of radiologists changed their opinion compared to 5.2% of urologists (p < 0.001). The change favored DJS. In the second scenario, responders preferred equally DJS and they did not change their opinion. In the third scenario, 41% of radiologists chose PN as opposed to 12.6% of urologists (p < 0.001). After reading the literature, 17.9% of radiologists changed their opinion compared to 17.9% of urologists (p < 0.001), in favor of DJS. Although the majority of urologists (63.4%) consistently perform primary URS, only 3, 37 and 21% preferred it for the first, second and third scenarios, respectively. Conclusion The decision on the type of drainage of a stone-obstructing hydronephrosis should be individualized.