Emergency upper urinary tract decompression: double-J stent or nephrostomy? A European YAU/ESUT/EULIS/BSIR survey among urologists and radiologists
Por:
Pietropaolo, A, Seoane, LM, Abadia, AAS, Geraghty, R, Kallidonis, P, Tailly, T, Modi, S, Tzelves, L, Sarica, K, Gozen, A, Emiliani, E, Sener, E, Rai, BP, Hameed, ZBM, Liatsikos, E, Rivas, JG, Skolarikos, A, Somani, BK
Publicada:
1 jul 2022
Ahead of Print:
1 mar 2022
Resumen:
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.
Filiaciones:
Pietropaolo, A:
Univ Hosp Southampton, Urol, Southampton, Hants, England
Seoane, LM:
Complexo Hosp Univ Ourense, Orense, Spain
Abadia, AAS:
Complexo Hosp Univ Ourense, Orense, Spain
Geraghty, R:
Freeman Rd Hosp, Dept Urol, Newcastle Upon Tyne, Tyne & Wear, England
Kallidonis, P:
Univ Patras, Patras, Greece
Tailly, T:
Univ Ziekenhuis Ghent, Ghent, Belgium
Modi, S:
Univ Hosp Southampton, Southampton, Hants, England
Tzelves, L:
Natl & Kapodistrian Univ Athens, Urol, Athens, Greece
Sarica, K:
Biruni Univ, Med Sch, Istanbul, Turkey
Gozen, A:
Trakya Tip Fak Hosp, Edirne, Turkey
Emiliani, E:
Fundacio Puigvert, Dept Urol, Barcelona, Spain
Sener, E:
Marmara Univ, Sch Med, Dept Urol, Istanbul, Turkey
Rai, BP:
Freeman Rd Hosp, Dept Urol, Newcastle Upon Tyne, Tyne & Wear, England
Hameed, ZBM:
Manipal Acad Higher Educ, Kasturba Med Coll Manipal, Dept Urol, Manipal, India
Liatsikos, E:
Univ Patras, Patras, Greece
Rivas, JG:
Hosp Clin San Carlos, Dept Urol, Madrid, Spain
Skolarikos, A:
Natl & Kapodistrian Univ Athens, Urol, Athens, Greece
Somani, BK:
Univ Hosp Southampton, Urol, Southampton, Hants, England
Bronze, Green Published
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