Preoperative double-J stent placement can improve the stone-free rate for patients undergoing ureteroscopic lithotripsy: a systematic review and meta-analysis

Yang, Yubo; Tang, Yin; Bai, Yunjin; Wang, Xiaoming; Feng, Dechao; Han, Ping

doi:10.1007/s00240-017-1012-z

Cited by 25 publications

(30 citation statements)

References 14 publications

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“…The analysis demonstrated a higher stone free rate for pre-stented renal stones, but no benefit for ureteric stones [28] . These results were confirmed in a recent meta-analysis of nine retrospective studies, including 11 239 patients, identifying a stone-free rate in favour of pre-stented patients (OR [95%CI]: 1.6 [1.19, 2.15]) [29] .…”

Section: Indicationsmentioning

confidence: 54%

Ureteral stents in urolithiasis

Beysens

Tailly

2018

Asian Journal of Urology

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Ever since the ureteral stent design was fitted with a curl on both sides to prevent it from migrating up or down the ureter some 40 years ago, its use has gained tremendous momentum, aiding in the rise and evolution of endourology and has confidently kept its place in modern time urology. Over the past four decades, several designs, coating and biomaterials have been developed, trying to reduce infection, encrustation and other stent related symptoms. As the ideal stent has not yet been discovered, different ways of helping patients with their complaints have been researched. This review will cover these aspects of stent use in urolithiasis.

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Section: Indicationsmentioning

confidence: 54%

Ureteral stents in urolithiasis

Beysens

Tailly

2018

Asian Journal of Urology

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“…Preoperative ureteral stenting may affect the success rate of the URS. A meta-analysis of nine retrospective studies with a total of 11,239 patients showed a higher SFR if the patient had received a preoperative ureteral stent [25], confirmed in other studies [26]. If the positive effect on SFR by preoperative stenting is due to stone location / stone burden or by stenting itself, remains unclear [9].…”

Section: Discussionmentioning

confidence: 87%

Ureteroscopy: a population based study of clinical complications and possible risk factors for stone surgery

Wagenius

Rydberg

Popiołek

et al. 2019

Cent european J Urol

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IntroductionThe aim of this study was to describe the complications of ureteroscopy (URS) and to investigate whether performing URS outside normal working hours leads to increased risk for clinically significant complications.Material and methodsA cohort of 486 consecutive patients treated with URS, with a total of 567 sessions between 2009 and 2015 at Helsingborg/Ängelholm Hospital, Sweden, was analyzed. Outcome was complications within 14 days after URS treatment.ResultsWe found no increased risk of complications related to URS performed outside normal working hours. Stone-free rate (SFR) in the distal third of the ureter was 95.2% (315/331), in the middle ureter 92.8% (90/97), in the proximal ureter 84.0% (63/75) and 69.0% (40/58) in renal pelvis. The overall complication rate was 10.6% (n = 60). None of the potential risk factors for complications showed any significance when adjusted for age and gender. We found an inverse relationship between stenting and SFR (p = 0.002). The most common preoperatively cultured bacteria was Escherichia coli. With adequate antibiotics, there was no increased risk of complications. There was an increased risk of complications after URS related to age, but not with gender.ConclusionsURS in modern setting provides excellent results with adequate SFR and low morbidity. Time of day, the presence of urological specialized operating nurses did not affect the risk of complications and we found no other significant risk factors for complications. Escherichia coli was the most commonly found bacteria in preoperative cultures. The risk of complications increases with age. For patients >65 years old, this should be considered in preoperative counseling.

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“…1a). Pre-stenting can improve the passive dilation of the ureter and increase the stone-free rate during URSL [11,12]. It has been reported that bacteriuria and bacterial colonization of the stent occurs over time after stent placement [13].…”

Section: Discussionmentioning

confidence: 99%

Optimal Timing of Ureteroscopic Lithotripsy after the Initial Drainage Treatment and Risk Factors for Postoperative Febrile Urinary Tract Infection in Patients with Obstructive Pyelonephritis: A Retrospective Study

Itami

Miyake²,

Miyake

et al. 2020

Preprint

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Background: A history of preoperative obstructive pyelonephritis has been reported as a risk factor for febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URSL). But there is no clear evidence of risk factors for developing fUTI including the optimal timing of URSL after obstructive pyelonephritis treatment.Methods: Of the 1361 patients, who underwent URSL at our hospital from January 2011 to December 2017, 239 patients had a history of pre-URSL obstructive pyelonephritis. The risk factors were analyzed by comparing the patients’ backgrounds with the presence or absence of fUTI after URSL. The factors examined were age, gender, body mass index, comorbidity, presence or absence of preoperative ureteral stent, stone position, stone laterality, stone size, Hounsfield unit (HU) value on computed tomography scan, history of systemic inflammatory response syndrome (SIRS) during obstructive pyelonephritis, period from antipyresis to URSL, ureteral stenting period, operation time, and presence or absence of access sheath at URSL. In addition, the stone components and renal pelvic urinary culture bacterial species during pre-URSL pyelonephritis were also examined.Results: Post-URSL fUTI developed in 32 of 239 patients (13.4%), and 11 of these 32 cases led to SIRS (34.4%). Univariate analysis showed that stone position, stone maximum HU value, presence of SIRS during obstructive pyelonephritis, period from antipyresis to URSL, pre-URSL ureteral stent placement, operation time were risk factors of fUTI. Stone components and urinary cultures during pyelonephritis were not associated with risk of fUTI. Multivariate analysis showed that renal stone position, pre-URSL ureteral stent placement > 21 days, and operation time > 75 minutes were independent risk factors of fUTI following the URSL.Conclusions: F-UTI following the URSL could be avoided by ureteral stent placement period 21 days or less and operation time 75 minutes or less in patients with obstructive pyelonephritis.

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Preoperative double-J stent placement can improve the stone-free rate for patients undergoing ureteroscopic lithotripsy: a systematic review and meta-analysis

Cited by 25 publications

References 14 publications

Ureteral stents in urolithiasis

Ureteral stents in urolithiasis

Ureteroscopy: a population based study of clinical complications and possible risk factors for stone surgery

Optimal Timing of Ureteroscopic Lithotripsy after the Initial Drainage Treatment and Risk Factors for Postoperative Febrile Urinary Tract Infection in Patients with Obstructive Pyelonephritis: A Retrospective Study

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