The impact of nephrostomy balloon inflation volume on post percutaneous nephrolithotomy hemorrhage

Pan Afr Med J. 2020 Aug 31:36:384. doi: 10.11604/pamj.2020.36.384.25162. eCollection 2020.

Abstract

Introduction: the study aims to match different volumes of nephrostomy balloon inflation to point out the foremost effective volume size of post percutaneous nephrolithotomy (PCNL) bleeding control.

Methods: we have retrospectively reviewed "560" medical records of patients who underwent percutaneous nephrolithotomy between (the years 2017 and 2018) at Prince Hussein Urology Center. The Patients were divided into two teams, group-1 (a number of 280 patients) with nephrostomy balloon inflated concerning three ml and group-2 (a number of 280 patients) the balloon inflated concerning one ml. The preoperative and postoperative hematocrit, the operation duration, the stone size, the postoperative pain severity, the transfusion rate and the duration of hematuria between the two groups were compared during hospitalization.

Results: regarding patients with ages (between 18 and 68 years); the preoperative hematocrit (mean values ± SDs) was (40.35% ± 3.57) vs (39.95% ± 3.43) for groups-1 and 2, respectively; the p value=0.066. The postoperative hematocrit was (37.91% ± 3.96) vs (34.38 ± 2.78), respectively; the p value was (0.008); the blood transfusion rate was 11.2% vs 13.4% (the p value was 0.039), respectively. The Postoperative pain score was (4.93 ± 1.44) vs (3.89 ± 1.45) (the p value was 0.012), respectively.

Conclusion: increasing the nephrostomy balloon volume to a "3cc" competes for a task to decrease bleeding which was found to be as a secure and considerable effective procedure-related factor. However, the disadvantage of this technique resulted in increasing the postoperative pain in patients undergoing such a procedure.

Keywords: Percutaneous nephrolithotomy (PCNL); nephrostomy balloon catheter; post-PCNL bleeding.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Balloon Occlusion / methods*
  • Balloon Occlusion / statistics & numerical data
  • Blood Transfusion / statistics & numerical data
  • Dilatation
  • Female
  • Humans
  • Insufflation
  • Kidney Calculi / surgery
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Nephrolithotomy, Percutaneous / adverse effects*
  • Nephrolithotomy, Percutaneous / statistics & numerical data
  • Nephrotomy / methods*
  • Nephrotomy / statistics & numerical data
  • Pain, Postoperative / epidemiology
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / therapy*
  • Retrospective Studies
  • Young Adult