Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis

Abstract

PurposeTo clarify the outcome of flexible ureteroscopy (fURS) for management of renal calculi without preoperative stenting.MethodsA total of 171 patients who received 176 fURS procedures for unilateral renal stones were reviewed. All procedures were divided into two groups depending on whether they received ureteral stenting preoperatively. Baseline characteristics of patients, stone burden, operation time, stone-free rates, and complications were compared between both groups.ResultsSuccessful primary access to the renal pelvis was achieved in 104 of 114 (91.2%) patients without preoperative stenting, while all procedures with preoperative stenting (n = 62) were successfully performed. A total of 156 procedures were included for further data analysis (56 procedures in stenting group and 100 in non-stenting group). No significant differences was found regardless of a preoperative stent placement in terms of stone-free rate (73.2% with stenting vs. 71.0% without, P = 0.854), operative time (70.4 ± 32.8 with stenting vs. 70.2 ± 32.1 without, P = 0.969).ConclusionsfURS for management of renal stone without preoperative ureteral stenting are associated with well outcome in short term follow-up. Our study may help patients and doctors to decide if an optional stent is placed or not.

Analysis of Prestenting on Outcomes of Flexible Ureteroscopy for Upper Urinary Urolithiasis: A Historical Control Study

“…Previous studies reported high insertion rate and low complication rate of UAS in the PS system [1,4,7,8]. However, successful insertion of UAS for NPS group was still not good enough with a failure rate of almost 10% in low complication study [8]. Our data showed some interesting findings of an intentional PS.…”

“…UAS via a guide wire was recommended by EAU guidelines in the practice of fURS, with decreased risk of ureteral damage and easy multiple access to the upper urinary tract. Previous studies reported high insertion rate and low complication rate of UAS in the PS system [1,4,7,8]. However, successful insertion of UAS for NPS group was still not good enough with a failure rate of almost 10% in low complication study [8].…”

“…The impact of PS on the SFR of urinary stones treatment is controversial, especially for fURS only [5,8,10]. Most of the studies report no significant difference in renal stones, but the SFR in ureteral stones was found out to be significantly different.…”

“…The 1 patient whose UAS failed in the PS group received fURS without UAS and the stones were fragmented without complications. In the previous study, Zhang et al [8] and Ambani et al [9] reported a similar treatment for UAS-failed patients. Those patients were dealt with good prognosis.…”

Ureteroscopic Lithotripsy versus Laparoscopic Ureterolithotomy or Percutaneous Nephrolithotomy in the Management of Large Proximal Ureteral Stones: A Systematic Review and Meta-Analysis

“…The mean size of stones in 5 studies was more than 20 mm. However, preoperative stenting is frequently used to allow passive ureteral dilatation, which is supposed to facilitate the passage of a flexible ureteroscope or ureteral access sheath [40] . At this point, one fact that cannot be ignored is that ESWL may result in additional stent-related complications compared to PCNL or LU, which not need use a preoperative stent.…”