Factors Affecting Post Nephrostomy Removal Urinary Leakage after Percutaneous Nephrolithotomy (PCNL)

Abstract

Background: Prolonged urinary leakage after nephrostomy tube removal leads to increased morbidity of PCNL and increased hospitalization. Objective: To evaluate factors affecting post nephrostomy removal urinary leakage after percutaneous nephrolithotomy. Patients and Methods: One hundred eight (108) patients older than 18 years who underwent PCNL were studied prospectively. The reasons that can affect urinary leakage postoperatively were divided into 4 categories according to individual factors including age, gender, and body mass index; Renal factors; including, previous operation, history of ESWL, parenchymal cortical thickness, and grades of hydronephrosis; stone factor (stone burden); and surgical factors including the number of tracts, presence of double J stent, nephrostomy tube diameter and stay duration. These data were compared for postoperative urine leak. Results: Urinary leakage was revealed in 76 of 108 patients (70.3%). There was no statistically significant relationship between individual factors and urinary leakage (P >0.05). Among renal factors, just parenchymal cortical thickness and grade of hydronephrosis were strongly related to the urinary leakage (P <0.001). The renal stone burden did not affect urinary leakage (P >0.05). Among surgical factors, placing of ureteral double-J stent highly minimized the incidence of urinary leakage (P<0.001), and the urinary leakage significantly correlated with the increased diameter of the nephrostomy tube and staying duration (P<0.05). Conclusion: After PCNL surgery, some factors show to influence post-PCNL urinary leakage. however most of the urinary leakage was treated conservatively, but it increases morbidity and hospitalization.