Percutaneous Nephrostomy Before Ureteral Reconstruction: Providing Ureteral Rest, But At What Cost?

Purpose Ureteral stent removal with pre-operative placement of percutaneous nephrostomy (PCN) allows for a period of ureteral rest. To better understand the impact on pre-operative PCN placement on patient quality of life (QoL), we created a novel questionnaire to distribute to our patients with questions pertaining to pain, general health, work performance, sexual matters, ease of follow-up, and urinary symptoms. Methods We retrospectively surveyed 20 patients with pre-operative PCN before ureteral reconstruction. Questions ranged from strongly disagree (1) to strongly agree (5) on a 5-point Likert-scale. Results Of 20 total patients surveyed, 65% strongly agreed or agreed that PCN improved their pain prior to surgery with an average score of 3.9 (95% CI 3.31–4.49). Overall, 65% of patients strongly agreed or agreed that PCN made it challenging to enjoy everyday activities with an average score of 3.8 (95% CI 3.16–4.44). For work performance, 70% of patients strongly disagreed or disagreed that the quality of their work was diminished with an average score of 2.05 (95% CI 1.44–2.66). In terms of overall satisfaction, 95% of patients strongly agreed or agreed that they were happy to have a PCN due to an increased likelihood of having a successful surgery with an average score of 4.8 (95% CI 4.6-5.0). Conclusions Pre-operative PCN placement did not significantly impact patient’s QoL in terms of overall satisfaction and should continue to be employed for ureteral rest prior to ureteral reconstruction. This tool can be further utilized to quantify the personal implications of a PCN on patients.