Comparison Efficacy between Percutaneous Nephrostomy and Double J Stent in Management of Obstructive Uropathy

Main Article Content

Saeed Ahmed Khan
Naresh Kumar
Khuda Bux
Muneer Ahmed Chachar
Abdul Karim Bangwarah


Background: The prevalence of urolithiasis and associated acute kidney injury (AKI) has seen a notable increase in recent decades, particularly in developing countries such as Pakistan, which falls within the "stone forming belt" region. This rise has underscored the need for effective management strategies for obstructive uropathy, a potentially reversible condition if timely intervention is provided. However, the literature reveals a divergence in treatment approaches between different regions and among healthcare professionals, with no universally recommended treatment for relieving the obstructed system.

Objective: This study aimed to evaluate and compare the efficacy of percutaneous nephrostomy (PCN) versus Double J stent (DJS) in the management of obstructive uropathy secondary to urolithiasis in patients with elevated serum creatinine levels.

Methods: Conducted as a randomized controlled trial at the Jinnah Postgraduate Medical Center Karachi from January 2023 to December 2023, the study included patients aged 20 to 50 years with obstructive uropathy secondary to urolithiasis and serum creatinine above or equal to 2.0 mg/dL. Exclusion criteria encompassed obstructive uropathy due to bladder outlet obstruction, uncontrolled coagulopathy, and lack of consent. Participants were randomized into two groups for either PCN or DJS placement, with pre-operative and post-procedure serum creatinine and urea levels measured at multiple intervals. Data analysis was performed using SPSS version 25.

Results: The study enrolled 30 patients in the PCN group and 30 in the DJS group. Efficacy rates for PCN and DJS were 93.3% (28 out of 30) and 76.7% (23 out of 30), respectively. Stratified analysis revealed no statistically significant differences in efficacy based on age, gender, or duration of illness, although a trend favoring PCN was observed in patients over 40 years and those treated within 5-10 days of illness onset.

Conclusion: While both PCN and DJS are effective interventions for obstructive uropathy secondary to urolithiasis, PCN showed a non-significantly higher overall efficacy. These findings suggest a potential preference for PCN in certain patient subsets, though further research with larger sample sizes and multi-center trials is needed to substantiate these observations.

Article Details

How to Cite
Khan, S. A., Kumar, N., Bux, K., Chachar, M. A., & Bangwarah, A. K. (2024). Comparison Efficacy between Percutaneous Nephrostomy and Double J Stent in Management of Obstructive Uropathy. Journal of Health and Rehabilitation Research, 4(1), 1339–1342.
Author Biographies

Saeed Ahmed Khan, Jinnah Postgraduate Medical Centre Karachi Pakistan.

Senior Registrar, Department of Urology and Transplantation, Jinnah Postgraduate Medical Centre Karachi, Pakistan.

Naresh Kumar, Jinnah Postgraduate Medical Center Karachi Pakistan.

Associate Professor, Department of Urology and Transplantation, Jinnah Postgraduate Medical Centre Karachi, Pakistan.

Khuda Bux, Jinnah Postgraduate Medical Center Karachi Pakistan.

Senior Registrar, Department of Urology and Transplantation, Jinnah Postgraduate Medical Centre Karachi, Pakistan.

Muneer Ahmed Chachar, Sheikh Jaber Al-Ahmed Al-Jaber Al-Sabah Hospital Kuwait.

Senior Registrar, Department of Urology, Sheikh Jaber Al-Ahmed Al-Jaber Al-Sabah Hospital, Kuwait.

Abdul Karim Bangwarah, Jinnah Postgraduate Medical Center Karachi Pakistan.

Resident, Department Of Urology and Transplantation, Jinnah Postgraduate Medical Centre Karachi, Pakistan.


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