Objective: To compare the effectiveness and safety of retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) in the treatment of diabetic patients with infected ureteral obstruction.
Methods: From February 2022 to February 2024, 202 diabetic patients with infected ureteral obstruction were included. Data were obtained retrospectively and the outcomes including complications, period for return to serum creatinine nadir, white blood cell (WBC) count and blood urea nitrogen were measured. Logistic regression was used to explore risk factors for postoperative complications.
Results: A total of 202 patients (PCN group: 102 patients; RUS group: 100 patients) were included in the final analysis. The incidence of complications of Clavien-Dindo Grade ≥ II was significantly higher in the PCN group (34.3%) than in the RUS group (11.0%, p < 0.001). The RUS group showed better renal function preservation rate (87.0% vs. 73.5%, p = 0.016) and lower recurrent urinary tract infection rate (11.0% vs. 21.6%, p = 0.042). After adjusting for potential confounding factors, the RUS group had a significantly lower risk of postoperative complications compared with the PCN group. In addition, the duration of diabetes mellitus, the amplitude of postoperative blood glucose fluctuation, and the duration of insulin use were independent risk factors for postoperative complications (p < 0.05).
Conclusions: RUS appears to be superior to PCN in reducing postoperative complications, preserving renal function, and lowering infection recurrence in diabetic patients with infected ureteral obstruction.
Keywords: diabetes; infection; percutaneous nephrostomy; retrograde ureteral stent; ureteral obstruction.
© 2026 The Author(s).