The Burden on a Urologist of Percutaneous Nephrostomies and Antegrade Ureteric Stents: should Trainee Urologists Learn to Perform these Procedures?

Main Article Content

JACK DONATI-BOURNE
Shahd Seifeldin Nour
Zain Siddiqui
Richard Viney

Keywords

nephrostomy, antegrade stent, training, urologist, emergency

Abstract

Abstract


 


Background and Objective


Renal obstruction is a common urological emergency potentially requiring urgent decompression by percutaneous nephrostomy (PCN) or antegrade ureteric stent (AUrS), procedures performed by interventional radiologists, or retrograde stenting in theatre by a urologist.


The study aimed to assess the burden of PCN / AUrS on the overall workload of a urology department and evaluate impact of procedural delays in terms of bed-occupancy and cost.


The findings serve to explore whether formal PCN / AUrS training would be desirable for UK trainees in urology.


 


Material and Methods


Prospective study of all patients admitted under urology at Queen Elizabeth Hospital Birmingham (QEHB) between 20thOctober - 18thNovember 2018.


Electronic records to retrieve data pertaining to admission, treatment provided, length of in-patient stay and delay awaiting PCN / AUrS.


 


Results


n=148 patients identified.


n=22 (14.8% of total) primary admission reason and/or main treatment provided related to PCN / AUrS.


601 urology in-patient days occupied for all causes, 166 (27.6%) related to PCN / AUrS and 66 (10.9%) awaiting PCN / AUrS (delays cost £11,361 / month).


 


Conclusion


PCN / AUrS constituted a noteworthy proportion of all admissions and in-patient bed days in QEHB urology.


Clinically non-urgent patients experienced notable cumulative delays whilst awaiting PCN / AUrS which adversely impacted bed occupancy.


A suitably trained urologist competent at PCN / AUrS may positively address these issues.


The findings merit consideration of a call for UK urology trainees to be trained in PCN / AUrS as part of CCT requirements.


 

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