Percutaneous nephrostomy tube versus double J ureteric stent for the management of non-septic calcular anuria in adults: Prospective randomized study.

Objective: To compare the use of JJ and PCN tubes as initial urinary drainage methods in patients with obstructive calcular anuria.

Methods: Between January 2021 and January 2024, 239 eligible patients with obstructive calcular anuria were randomly classified into two groups. Group A (JJ group) included 121 patients and group B (PCN group) included 118 patients. Laboratory data, stone characteristics, and intraoperative and postoperative data were also collected. The time needed to normalize the serum creatinine levels, postoperative complications, and quality of life scores were assessed.

Results: The procedures had comparable success rates (86.8% vs. 90.7%; p = 0.9). The PCN group had a shorter operative time (p < 0.001). No significant differences were observed in the time required for serum creatinine to return to normal between the two groups (p = 0.669). Fever, haematuria, and LUTS were more evident in the JJ stent group. In the JJ group, the presence of upper ureteral stones and stone burden were risk factors for procedure failure, whereas the presence of upper ureteral stones and preoperative serum creatinine were risk factors for ureteral perforation. Mild hydronephrosis was a risk factor for procedural failure in the PCN group. Spontaneous stone passage was more common in the PCN group (p = 0.028). The Overall quality of life and general health scores were significantly better in the PCN group (p < 0.001).

Conclusions: Both PCN and JJ stents had comparable success rates. PCN was associated with a lower incidence of LUTS, higher incidence of spontaneous stone passage, and better quality of life scores than the JJ stent.