Comparative Analysis of PCNL Approaches: Outcomes of Double-J Stent, Nephrostomy, and Kaye Balloon Catheter on Bleeding and Infection

Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical technique widely utilized for the removal of large or complex kidney stones, offering a high success rate and reduced morbidity compared to open surgery. A critical component of PCNL is the choice of postoperative drainage methods, which significantly influences patient outcomes, including bleeding and infection rates. This review examines and compares the clinical outcomes of PCNL when paired with three commonly used drainage methods: Double-J stent, nephrostomy tube, and Kaye nephrostomy balloon catheter. The Double-J stent is frequently used for internal drainage, minimizing external discomfort while maintaining urinary flow from the kidney to the bladder. However, stent-associated complications such as stent syndrome and urinary tract infections remain concerns. In contrast, the nephrostomy tube, often considered the traditional approach, provides external drainage, which can offer advantages in monitoring and managing postoperative bleeding but may increase patient discomfort and infection risk. The Kaye nephrostomy balloon catheter, a relatively less common method, combines the benefits of temporary external drainage and hemostasis due to its tamponading effect, potentially reducing bleeding risks. By synthesizing data from recent studies, this review highlights the bleeding and infection rates associated with each drainage method. The article provides clinicians with an evidence-based perspective to facilitate informed decision-making tailored to individual patient needs, considering factors such as stone size, location, and patient comorbidities. Additionally, the discussion explores the role of advancements in PCNL techniques, including miniaturized instruments and modifications to drainage strategies, in further reducing complications and improving patient outcomes.

کلیدواژه ها:

Percutaneous nephrolithotomy (PCNL) ، kidney stones ، postoperative drainage methods ، Double-J stent ، nephrostomy tube ، Kaye nephrostomy balloon catheter ، bleeding rates ، infection rates