Application of nephrostomy tubes with balloon after percutaneous nephrolithotomy: A randomized controlled clinical trial

Objective To evaluate the effect of nephrostomy tubing with balloon on postoperative hemorrhage after percutaneous nephrolithotomy. Methods A total of 284 patients with upper urinary calculi were enrolled for blocked randomization with 71 blocks and block length of 4. The experimental group consisted of 143 patients receiving 14-Fr silicone tubing with balloon, and the control group consisted of 141 patients receiving 14-Fr silicone tubing without balloon. One patient in the control group developed intraoperative bleeding as a result of calyceal laceration, and was reassigned to the experimental group receiving nephrostomy tubing with balloon. Results Postoperative drop in hemoglobin level at 3 days was significantly less in the experimental group (3.31 ± 2.85 g/L) compared with the control group (5.14 ± 3.43 g/L) (P < 0.001). The duration of gross hematuria, defined by urine with visible light or bright red color (2.73 ± 1.59 days vs 3.55 ± 2.09 days, P < 0.001), and the incidence of postoperative extravasation (22/143 vs 38/141, P < 0.05) for patients in the experimental group (implanted with 14-Fr silicone tubing with balloon) were significantly lower compared with the control group. Conclusion Use of indwelling nephrostomy tubes with balloon after percutaneous nephrolithotomy can reduce blood loss. Further consideration for more widespread adoption of this type of tubing to limit perioperative bleeding complications is warranted.