why dpuble- j is better than external ureteral catheter in staghorn stones with tubless pcnl?

Double-J stents are often preferred over external ureteral catheters in the management of staghorn stones with tubeless percutaneous nephrolithotomy (PCNL) for several reasons:

1. Reduced Urinary Leakage: Double-J stents are placed internally, from the kidney to the bladder, reducing the chance of urinary leakage which is a common issue with external catheters.

2. Patient Comfort: Patients generally find internal stents more comfortable as they do not have an external device attached to them. This can also reduce the risk of accidental catheter removal.

3. Lower Infection Risk: The risk of urinary tract infections is generally lower with internal stents as compared to external catheters, as there is no open pathway for bacteria to enter the body.

4. Longer Term Use: Double-J stents can be left in place for longer periods of time compared to external catheters, which is beneficial in cases where prolonged drainage is required.

5. Improved Drainage: Double-J stents can provide better drainage of the upper urinary tract, which is particularly important in patients with staghorn stones to prevent obstruction and kidney damage.

6. Allows for Spontaneous Stone Passage: The presence of a Double-J stent can also facilitate the spontaneous passage of any residual stone fragments following PCNL.

However, the choice between a Double-J stent and an external ureteral catheter should be individualized based on the patient's specific condition, the size and location of the stones, and the surgeon's experience and preference.