Top

Published in:

01-07-2019 | Original Article

The effect of short-term preoperative ureteral stenting on the outcomes of retrograde intrarenal surgery for renal stones

Authors: Min Ho Lee, In Jae Lee, Tae Jin Kim, Sang Chul Lee, Chang Wook Jeong, Sung Kyu Hong, Seok-Soo Byun, Jong Jin Oh

Published in: World Journal of Urology | Issue 7/2019

Abstract

Objectives

To evaluate the effect of preoperative ureteral stenting duration on the outcomes of retrograde intrarenal surgery (RIRS).

Patients and methods

We reviewed our database of patients who underwent RIRS between May 2011 and April 2017 at our institution. The patients were divided into three groups according to preoperative ureteral stenting duration: group 1: no stenting, group 2: short preoperative stenting (< 7 days) and group 3: long preoperative stenting (≥ 7 days). We compared the rate of ureteral injury, other perioperative complications, ureteral dilation and readmission, stone-free rate (SFR) and operative time among the groups.

Results

A total of 560 patients (215 in group 1, 177 in group 2 and 168 in group 3) were included in this study. The mean of maximum stone size was 13.1 (± 6.2) mm, the mean number of stones was 2.3 (± 1.9) and preoperative ureteral stenting duration was 7.2 (± 3.7) days. There were no significant differences in operative time (75.6, 78.5 and 82.4 min, p = 0.280), SFR (79.1, 84.2 and 81.0%, p = 0.433), ureteral injury rate (7.0, 5.1 and 2.4%, p = 0.123) and other perioperative complication rates (12.1, 6.8 and 6.0%, p = 0.061). The only one case of grade IV ureteral injury occurred in group 1 and the rate of ureteral dilation was significantly higher than in group 2 and 3 (14.9, 5.7 and 6.0%, p < 0.001).

Conclusion

Although preoperative ureteral stenting duration has no significant effect on operative outcomes, it is an effective procedure for reducing the rate of intraoperative ureteral balloon dilation and preventing high-grade ureteral injuries.

Al-Marhoon MS, Shareef O, Venkiteswaran KP (2012) Complications and outcomes of JJ stenting of the ureter in urological practice: a single-centre experience. Arab J Urol 10:372–377CrossRefPubMedPubMedCentral

Auge BK, Pietrow PK, Lallas CD et al (2004) Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol 18:33–36CrossRefPubMed

Bach C, Nesar S, Kumar P et al (2012) The new digital flexible ureteroscopes: ‘Size Does Matter’—increased ureteric access sheath use! Urol Int 89:408–411CrossRefPubMed

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral

Fabrizio MD, Behari A, Bagley DH (1998) Ureteroscopic management of intrarenal calculi. J Urol 159:1139–1143CrossRefPubMed

Ghani KR, Wolf JS Jr (2015) What is the stone-free rate following flexible ureteroscopy for kidney stones? Nat Rev Urol 12:281–288CrossRefPubMed

Joshi HB, Stainthorpe A, MacDonagh RP (2003) Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol 169:1065–1069CrossRefPubMed

Lumma PP, Schneider P, Strauss A et al (2013) Impact of ureteral stenting prior to ureterorenoscopy on stone-free rates and complications. World J Urol 31:855–859CrossRefPubMed

Mousavi-Bahar SH, Mehrabi S, Moslemi MK (2011) Percutaneous nephrolithotomy complications in 671 consecutive patients: a single-center experience. Urol J 8:271–276PubMed

10.

Netsch C, Knipper S, Bach T et al (2012) Impact of preoperative ureteral stenting on stone-free rates of ureteroscopy for nephroureterolithiasis: a matched-paired analysis of 286 patients. Urology 80:1214–1219CrossRefPubMed

11.

Perlmutter AE, Talug C, Tarry WF et al (2008) Impact of stone location on success rates of endoscopic lithotripsy for nephrolithiasis. Urology 71:214–217CrossRefPubMed

12.

Pietropaolo A, Proietti S, Geraghty R et al (2017) Trends of ‘urolithiasis: interventions, simulation, and laser technology’ over the last 16 years (2000–2015) as published in the literature (PubMed): a systematic review from European section of Uro-technology (ESUT). World J Urol 35:1651–1658CrossRefPubMedPubMedCentral

13.

Rehman J, Monga M, Landman J et al (2003) Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology 61:713–718CrossRefPubMed

14.

Resorlu B, Unsal A (2012) Comparison of percutaneous nephrolithotomy and retrograde flexible nephrolithotripsy for the management of 2–4 cm stones: a matched-pair analysis. BJU Int 109:4–6CrossRef

15.

Rubenstein RA, Zhao LC, Loeb S et al (2007) Prestenting improves ureteroscopic stone-free rates. J Endourol 21:1277–1280CrossRefPubMed

16.

Shields JM, Bird VG, Graves R et al (2009) Impact of preoperative ureteral stenting on outcome of ureteroscopic treatment for urinary lithiasis. J Urol 182:2768–2774CrossRefPubMed

17.

Stern JM, Yiee J, Park S (2007) Safety and efficacy of ureteral access sheaths. J Endourol 21:119–123CrossRefPubMed

18.

Traxer O, Thomas A (2013) Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol 189:580–584CrossRefPubMed

19.

Türk C, Petrik A, Knoll T et al (2016) EAU guidelines on interventional treatment for urolithiasia. Eur Urol 69:475–482CrossRefPubMed

20.

Vachon C, Defarges A, Brisson B et al (2017) Passive ureteral dilation and ureteroscopy after ureteral stent placement in five healthy Beagles. Am J Vet Res 78:381–392CrossRefPubMed

21.

Wang HH, Huang L, Routh JC et al (2011) Use of the ureteral access sheath during ureteroscopy in children. J Urol 186:1728–1733CrossRefPubMed

22.

Zhang J, Xu C, He D et al (2016) Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis. PeerJ 29:e2728CrossRef

Title: The effect of short-term preoperative ureteral stenting on the outcomes of retrograde intrarenal surgery for renal stones
Authors: Min Ho Lee
In Jae Lee
Tae Jin Kim
Sang Chul Lee
Chang Wook Jeong
Sung Kyu Hong
Seok-Soo Byun
Jong Jin Oh
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 7/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2519-9

At a glance: The STEP trials

Springer Medicine

The effect of short-term preoperative ureteral stenting on the outcomes of retrograde intrarenal surgery for renal stones

Abstract

Objectives

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Patients and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2019

Perioperative and long-term results of retroperitoneal laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for staghorn calculi: a single-center randomized controlled trial

Aquablation of the prostate: single-center results of a non-selected, consecutive patient cohort

Diagnosis and management of nocturia in current clinical practice: who are nocturia patients, and how do we treat them?

Does routine repeat imaging change management in high-grade renal trauma? Results from three level 1 trauma centers

Lower urinary tract dysfunction in chronic Chagas disease: clinical and urodynamic presentation

A comprehensive analysis of cost of an active surveillance cohort compared to radical prostatectomy as primary treatment for prostate cancer