Comparison of pre-indwelling double-J stents versus ureteral catheters for artificial hydronephrosis in percutaneous nephrolithotomy: A retrospective cohort study

PURPOSE: To compare the clinical efficacy and safety of pre-indwelling double-J stents versus ureteral catheters for artificial hydronephrosis in percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: We retrospectively analyzed the data of 1,258 patients who underwent PCNL for kidney stones from August 2017 to July 2020 in our hospital. Among them, 682 patients had double-J stents inserted (DJ group) and 576 patients had ureteral catheters (UC group). We analyzed baseline patient characteristics, perioperative outcomes, and complications in both groups. RESULTS: The puncture success rate was 97.9% and 97.4% in the DJ and UC groups, respectively (p>0.05). The operation time was 74.5±37.8 minutes in the DJ group compared with 80.8±38.5 minutes in the UC group (p=0.004). The total stone-free rate in the DJ and UC groups was 80.5% and 78.7%, respectively (p>0.05). The incidence of perioperative complications was relatively low in both groups and showed no obvious differences. In the subgroup analysis, the operation time for patients with no obvious or mild hydronephrosis preoperatively was significantly shorter in the DJ group than in the UC group (p<0.05). However, there were no significant differences among patients who had moderate or severe hydronephrosis preoperatively. CONCLUSIONS: It is feasible, safe, and effective to create artificial hydronephrosis by insertion of pre-indwelling double-J stents in PCNL surgery. Furthermore, the operation time was significantly shorter in the DJ group than in the group with pre-indwelling ureteral catheters, especially in patients who had no obvious or mild hydronephrosis preoperatively.