Primary and Secondary Percutaneous Ureteral Stent Placement: Comparison of Stent Patency and Clinical Outcome.

Objectives: To compare early double J ureteral stent (DJUS) dysfunction rate and long-term patency between two percutaneous ureteral stent placement methods: single-stage (primary) or two-stage (secondary) procedures.

Methods: A total of 250 (176 primary and 74 secondary) DJUS placements performed on interventional unit were retrospectively reviewed between February 2008 and March 2014. Early DJUS dysfunction was defined as no passage of contrast media into the urinary bladder in 2-3 days after placement. Long-term patency was considered if the ureteral stent functioned for 3 months (time point for a first routine DJUS change). Amount of blood retained in the collecting system was scored on nephrostogram immediately after DJUS placement with three levels of score.

Results: The overall early DJUS dysfunction rate and long-term patency rate were 30.8 and 96.7%. The early DJUS dysfunction rates were similar in primary and secondary DJUS placements (30.7 and 31.1%, P = 0.950). The long-term patency rates were similar in primary and secondary groups (96.2 and 97.9%, P = 0.928). The amount of blood retained in the collecting system between primary and secondary groups was not significantly different. The early DJUS dysfunction rate significantly increased with increasing blood retention.

Conclusions: The early DJUS dysfunction rates and long-term patency are similar in primary and secondary DJUS placement. However, the early DJUS dysfunction rate can be increased by increasing the blood retention in the collecting system.