Impact of ureteral stenting prior to ureterorenoscopy on stone-free rates and complications

Abstract

ObjectiveTo date, only few studies have evaluated the impact of ureteral stenting prior to ureterorenoscopy. This study is to clarify the role of preoperative ureteral stenting in the treatment for ureteral stones.MethodsWe retrospectively reviewed 550 ureterorenoscopies from 1998 to 2008. Patients were classified into two groups depending on whether they had a stent placed before URS. Baseline characteristics of patients and stone properties, stone-free rates, complications, and operation times were compared between both groups. Subanalysis was performed regarding stone localization. We retrospectively reviewed data from patient documentation, X-ray imagery, intravenous urography, and operation reports.ResultsBaseline characteristics of patients were similar in both groups. The majority of patients underwent stent placement before the ureteroscopic stone treatment (88.4%). The mean operation time in the prestented group was longer (43.3 vs. 38.4 min). Stone-free rate of patients with stent was 72.2%, compared to 59.4% without preoperative stenting. The rate of minor complications was 4.7% with stent versus 9.4% without stent, major complications 0.6% versus 1.6%, respectively. Patients with distal ureter stones had similar stone-free rates regardless of a stent placement (90.1% with stent vs. 87.6% without), and no difference in complication rates was observed (3.5% with stent vs. 3.1% without), respectively.ConclusionsStent placement prior to ureteroscopic stone treatment in distal ureter is not reasonable and does not considerably improve stone-free rates.

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

“…In this study, fURS was associated with a very low incidence of severe complications in both groups. Contrary to our findings, major complications were reported after URS in few studies, especially perforation of the ureter [3,4]. In these studies, PS was always passive.…”

“…Prestenting (PS) of fURS does not seem to be a controversial topic because guidelines suggest routinely performed PS is not necessary before fURS and recommended only in challenging cases [1]. However, selectively PS still induced a high complication rate in different centers from all the reported studies [3][4][5]. The reasons for PS were passive in most studies that support the above idea.…”

Emergency double-J stent insertion following uncomplicated Ureteroscopy: risk-factor analysis and recommendations

“…It is, however, thought to reduce post URS obstruction, facilitate clearance of stone fragments and decrease stricture rate (6,7).…”

Use of cystourethroscopy to remove an indwelling double-J ureteral stent 6 years following simultaneous radical sigmoid colon cancer and partial bladder resection: A case report

“…The D-J ureteral stent is one of the most basic and valuable tools used to prevent obstruction of the urinary tract and to maintain its patency following endourological procedures and urologic open surgery (9). The D-J stent enables direct drainage of the upper urinary tract into the bladder without the need for an external diversion (10).…”