BJU international · 2026
Patient-reported outcome measures of percutaneous nephrostomy vs JJ stent in obstructive urolithiasis: results of the STent Or NEphrostomy (STONE) randomised controlled trial.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Schuil Hugo W, Hendriks Nora, Duijnhoven Ruben G, Oskam Bart C H, Arends Tom J H, Duijvesz Diederick, Horsch Alexander D, van der Heij Bart, Tjiam Irene M, van Overhagen Hans, Lamers Armand B G N, van Delden Otto M, Scheepens Wout A, Drossaerts Jamie M A, d'Ancona Frank C H, Boering Steven, van Uhm Janneke I M, van der Meer Rutger W, van Roijen J Herman, de Kiefte Martin, Hendrikx Ad J M, Weltings Saskia, Pelger Rob C M, Beerlage Harrie P, Schout Barbara M A, Kamphuis Guido M
Аннотация
OBJECTIVE: To compare the effects of percutaneous nephrostomy (PCN) and JJ ureteric stent (JJ) for urinary tract decompression in patients with obstructive urolithiasis on health-related quality of life (HRQoL), pain scores, urinary symptoms, and patient satisfaction.
PATIENTS AND METHODS: In 11 hospitals, 204 patients with obstructive urolithiasis were randomised to JJ or PCN placement. Patient-reported outcome measures (PROMs) were assessed until stone passage, surgical removal, or at 3 months.
RESULTS: Both PCN and JJ effectively improved HRQoL index scores (PCN: pre-decompression 0.70, 1 day post-decompression 0.82, P = 0.003; JJ: pre 0.59, post 0.85, P < 0.001), pain scores (PCN: pre 4.9, post 1.3, P < 0.001; JJ: pre 5.5, post 1.3, P < 0.001), and achieved patient satisfaction (score at discharge PCN: 7.9; JJ: 8.2), with no significant differences between interventions in overall HRQoL (generalised estimating equation [GEE] P = 0.7) or mean daily pain scores (GEE P = 0.4). PCN led to more self-care difficulties (patients reporting no problems: PCN 74%, JJ 91%, P = 0.023), while JJ recipients reported more urinary symptoms and higher peak pain intensity (pain score PCN: 2.3, JJ: 3.7, between groups P = 0.018). Despite symptoms, more JJ recipients preferred the same intervention in future (60%), than PCN recipients (31%) (P < 0.001). Survey-based data collection may introduce response bias (response rate 59%).
CONCLUSION: In patients with obstructive urolithiasis, urinary decompression with PCN and JJ improved HRQoL and pain comparably. JJ causes more urinary symptoms and peak pain but allows better self-care. Baseline self-care and urinary symptoms should guide shared decision-making. Drainage duration should be minimised.
PATIENTS AND METHODS: In 11 hospitals, 204 patients with obstructive urolithiasis were randomised to JJ or PCN placement. Patient-reported outcome measures (PROMs) were assessed until stone passage, surgical removal, or at 3 months.
RESULTS: Both PCN and JJ effectively improved HRQoL index scores (PCN: pre-decompression 0.70, 1 day post-decompression 0.82, P = 0.003; JJ: pre 0.59, post 0.85, P < 0.001), pain scores (PCN: pre 4.9, post 1.3, P < 0.001; JJ: pre 5.5, post 1.3, P < 0.001), and achieved patient satisfaction (score at discharge PCN: 7.9; JJ: 8.2), with no significant differences between interventions in overall HRQoL (generalised estimating equation [GEE] P = 0.7) or mean daily pain scores (GEE P = 0.4). PCN led to more self-care difficulties (patients reporting no problems: PCN 74%, JJ 91%, P = 0.023), while JJ recipients reported more urinary symptoms and higher peak pain intensity (pain score PCN: 2.3, JJ: 3.7, between groups P = 0.018). Despite symptoms, more JJ recipients preferred the same intervention in future (60%), than PCN recipients (31%) (P < 0.001). Survey-based data collection may introduce response bias (response rate 59%).
CONCLUSION: In patients with obstructive urolithiasis, urinary decompression with PCN and JJ improved HRQoL and pain comparably. JJ causes more urinary symptoms and peak pain but allows better self-care. Baseline self-care and urinary symptoms should guide shared decision-making. Drainage duration should be minimised.