Two Weeks Too Long: Optimal Duration for Ureteral Prestenting and Its Physiologic Effects on the Ureter in a Yorkshire-Landrace Pig Model

Lim, Kheng Sit; Lim, Yong Wei; Yong, Daniel; Hui, Ying; Ho, Henry; Ng, Lay Guat; Sim, Allen

doi:10.1089/end.2018.0872

Cited by 7 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This threshold of 5 days is consistent with porcine data on ureteral dilation with stenting. 10 We acknowledge that stents with strings are an important method of stent deployment with advantages of lower removal costs with the greatest benefit being they are unlikely to be retained and forgotten. However, if patients remove their stent too early this may itself increase health care costs.…”

Section: Discussionmentioning

confidence: 99%

“…In a pilot study assessing 3- vs 7-day dwell times in patients with strings, 3-day stenting resulted in more postprocedure events such as phone calls, clinic visits, and ED visits. 4 Furthermore, a recent porcine study found that the ureter is maximally dilated after 5 days of stenting, 10 and so it might be that suboptimal ureteral dilation results in spasm and pain. Based on these data, we explored stent dwell time outcomes in our quality improvement ureteroscopy registry in Michigan.…”

mentioning

confidence: 99%

See 1 more Smart Citation

What Is the Optimal Stenting Duration After Ureteroscopy and Stone Intervention? Impact of Dwell Time on Postoperative Emergency Department Visits

et al. 2023

View full text Add to dashboard Cite

Purpose:AUA stone management guidelines recommend stenting duration following ureteroscopy be minimized to reduce morbidity; stents with extraction strings may be used for this purpose. However, an animal study demonstrated that short dwell time results in suboptimal ureteral dilation, and a pilot clinical study showed this increases postprocedure events. Using real-world practice data we examined stent dwell time after ureteroscopy and its association with postoperative emergency department visits.Materials and Methods:We used the Michigan Urological Surgery Improvement Collaborative registry to identify ureteroscopy and stenting procedures (2016-2019). Pre-stented cases were excluded. Stenting cohorts with and without strings were analyzed. Using multivariable logistic regression we evaluated the risk of an emergency department visit occurring on the day of, or day after, stent removal based on dwell time and string status.Results:We identified 4,437 procedures; 1,690 (38%) had a string. Median dwell time was lower in patients with a string (5 vs 9 days). Ureteroscopy in younger patients, smaller stones, or renal stone location had a higher frequency of string use. The predicted probability of an emergency department visit was significantly greater in procedures with string, compared to without string, when dwell times were less than 5 days (P < .01) but were not statistically significant after.Conclusions:Patients who had ureteroscopy and stenting with a string have short dwell times. Patients are at increased risk of a postoperative emergency department visit around the time of stent removal if dwell time is ≤4 days. We recommended stenting duration of at least 5 days in nonpre-stented patients.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

What Is the Optimal Stenting Duration After Ureteroscopy and Stone Intervention? Impact of Dwell Time on Postoperative Emergency Department Visits

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Lim и соавт. оценили влияние мочеточникового стента на эластичность верхних мочевых путей на моделях сви-ней и пришли к выводу, что эластичность мочеточников повышается [19]. P. Jiang и соавт.…”

Section: Discussionunclassified

Estimation of the results of laparoscopic pyeloplasty in primary strictures of the pelvic-ureteral segment.

Panferov,

Bekreev,

Malkhasyan

2023

ECU

View full text Add to dashboard Cite

Introduction. In 1993, W.W. Schuessler et al. laparoscopic pyeloplasty was reported, and since that time the number of interventions performed with such access has increased significantly. Laparoscopic pyeloplasty does not exclude possible complications, including early ones - urinary congestion, anastomosis failure and distant ones, restenosis and obliteration of the ureteral lumen, which can develop as a result of ischemia due to excessive tissue tension. There are isolated references in the literature about the positive effect of prestenting on the results of pyeloplasty. Objective. Estimate the results of laparoscopic pyeloplasty in patients without prestenting and with prestenting. Materials and methods. A retrospective analysis of the treatment of 73 patients with stricture of the pelvic ureteral segment is presented. All patients were divided into two groups: I (main) – 17 patients whose upper urinary tract was drained by a ureteral stent at the time of surgery, II (control) - 56 patients who had not previously had upper urinary tract drainage. Results. The results, nature and frequency of complications of laparoscopic pyeloplasty in patients with and without prestenting are analyzed. The average operation time in group I was about 153.85 minutes, in group II - 116.7 minutes, the average drainage time in group I was 22.1 hours, in group II - 30.8 hours. Requirement for analgesics: group I – 48.5 mg/day, group II – 56.2 mg/day. In group I, one complication (5.9%) of category 1 was recorded - an attack of pyelonephritis and one case of complications (5.9%) of category 3a (urinoma). In group II, 6 cases (10.7%) of category 1 complications, 9 cases (16.1%) of category 3a complications were recorded. The results according to MSCT, performed 3 months after surgery, demonstrated restoration of patency at the level of the ureteropelvic segment. Conclusions. Prestenting of the ureter reduces the frequency of postoperative complications during laparoscopic pyeloplasty and eliminates the need for additional mobilization of the kidney for the formation of ureteropyeloanastomosis without excessive tension.

show abstract

The Ureteral Response to Ureteral Stents

Herout,

Reicherz,

Lange

et al. 2023

The Ureter

View full text Add to dashboard Cite

Two Weeks Too Long: Optimal Duration for Ureteral Prestenting and Its Physiologic Effects on the Ureter in a Yorkshire-Landrace Pig Model

Cited by 7 publications

References 19 publications

What Is the Optimal Stenting Duration After Ureteroscopy and Stone Intervention? Impact of Dwell Time on Postoperative Emergency Department Visits

What Is the Optimal Stenting Duration After Ureteroscopy and Stone Intervention? Impact of Dwell Time on Postoperative Emergency Department Visits

Estimation of the results of laparoscopic pyeloplasty in primary strictures of the pelvic-ureteral segment.

The Ureteral Response to Ureteral Stents

Contact Info

Product

Resources

About