Is a ureteral stent required before flexible ureteroscopy?

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Abstract

Background

To retrospectively evaluate the therapeutic effectiveness and safety of flexible ureteroscopes without preoperative ureteral stent placement.

Methods

A total of 243 patients who had undergone flexible ureteroscopy (fURS) lithotripsy were reviewed. The patients were divided into two groups: 119 patients without preoperative ureteral stent placement were set as group A; and the remaining 124 patients who received preoperative ureteral stent placement were set as group B. The operative time, length of hospital stay, hospital costs, stone-free rates (SFRs), complications, and re-operation rates of the two groups were respectively compared.

Results

Pairwise analysis indicated the following: the average operative time of group A was longer than that of group B (66.53±10.19 versus 59.85±9.85 min, P=0.0001), the average length of hospital stay of group A was considerably shorter than that of group B (6.56±0.90 versus 10.67±1.50 d, P=0.0001), the SFRs of group A were significantly lower than those of group B at 3 days postoperatively (36.1%, 43/119 versus 51.6%, 64/124, P=0.0034), and the average hospital costs were substantially lower in group A than those in group B (18,756 versus 23,450 RMB, P=0.0001). However, there were no notable differences observed in the following: SFRs between the groups at 1 month postoperatively (84.0%, 100/119 of group A versus 85.5%, 106/124 of group B, P=0.895), complications rates (20.1%, 26/124 in group A versus 20.1%, 23/114 in group B, P=0.597), and re-operation rates (15.1%, 18/119 in group A versus 16.9%, 21/124 in group B, P=0.558).

Conclusions

These results indicated that fURS without preoperative ureteral stent placement is safe and effective for the treatment of upper urinary calculi.

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Most cited references 30

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EAU Guidelines on Interventional Treatment for Urolithiasis

Christian Türk, Aleš Petřík, Kemal Sarica … (2016)

Management of urinary stones is a major issue for most urologists. Treatment modalities are minimally invasive and include extracorporeal shockwave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PNL). Technological advances and changing treatment patterns have had an impact on current treatment recommendations, which have clearly shifted towards endourologic procedures. These guidelines describe recent recommendations on treatment indications and the choice of modality for ureteral and renal calculi.

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Epidemiology of stone disease across the world.

Yair Lotan, Igor Sorokin, Charalampos Mamoulakis … (2017)

Nephrolithiasis is a highly prevalent disease worldwide with rates ranging from 7 to 13% in North America, 5-9% in Europe, and 1-5% in Asia. Due to high rates of new and recurrent stones, management of stones is expensive and the disease has a high level of acute and chronic morbidity. The goal of this study is to review the epidemiology of stone disease in order to improve patient care. A review of the literature was conducted through a search on Pubmed®, Medline®, and Google Scholar®. This review was presented and peer-reviewed at the 3rd International Consultation on Stone Disease during the 2014 Société Internationale d'Urologie Congress in Glasgow. It represents an update of the 2008 consensus document based on expert opinion of the most relevant studies. There has been a rising incidence in stone disease throughout the world with a narrowing of the gender gap. Increased stone prevalence has been attributed to population growth and increases in obesity and diabetes. General dietary recommendations of increased fluid, decreased salt, and moderate intake of protein have not changed. However, specific recommended values have either changed or are more frequently reported. Geography and environment influenced the likelihood of stone disease and more information is needed regarding stone disease in a large portion of the world including Asia and Africa. Randomized controlled studies are lacking but are necessary to improve recommendations regarding diet and fluid intake. Understanding the impact of associated conditions that are rapidly increasing will improve the prevention of stone disease.

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Urologic diseases in America project: urolithiasis.

Margaret Pearle, Elizabeth Calhoun, Gary Curhan (2005)

We quantified the burden of urolithiasis in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease. The analytical methods used to generate these results have been described previously. The rate of national inpatient hospitalizations for a diagnosis of urolithiasis decreased by 15% and hospital length of stay decreased from 2.6 to 2.2 days between 1994 and 2000. Rates of hospitalization were 2.5 to 3-fold higher for Medicare beneficiaries with little change between 1992 and 1998. Almost 2 million outpatient visits for a primary diagnosis of urolithiasis were recorded in 2000. Hospital outpatient visits increased by 40% between 1994 and 2000 and physician office visits increased by 43% between 1992 and 2000. In the Medicare population hospital outpatient and office visits increased by 29% and 41%, respectively, between 1992 and 1998. The distribution of surgical procedures remained relatively stable through the 1990s. Shock wave lithotripsy was the most commonly performed procedure, followed closely by ureteroscopy. Overall the total estimated annual expenditure for individuals with claims for a diagnosis of urolithiasis was almost $2.1 billion in 2000, representing a 50% increase since 1994. The cost of urolithiasis is estimated at almost $2 billion annually and it appears to be increasing with time despite a shift in inpatient to outpatient treatment and the emergence of minimally invasive treatment modalities, perhaps because the prevalence of stone disease is increasing.

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Author and article information

Journal

Journal ID (nlm-ta): Transl Androl Urol

Journal ID (iso-abbrev): Transl Androl Urol

Journal ID (publisher-id): TAU

Title: Translational Andrology and Urology

Publisher: AME Publishing Company

ISSN (Print): 2223-4683

ISSN (Electronic): 2223-4691

Publication date (Print and electronic): December 2020

Publication date (Print): December 2020

Volume: 9

Issue: 6

Pages: 2723-2729

Affiliations

[1 ]Department of Urology, People’s Hospital of Longhua, Southern Medical University , Shenzhen, China;

[2 ]Department of Urology, Weifang People’s Hospital, Weifang, China

Author notes

Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: W Zhu, Y Lai, Q Deng, J Zhang, H Wang, H Liang; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

[#]

These authors contributed equally to this work.

Correspondence to: Hongjun Zhao. Department of Urology, Weifang People’s Hospital, No. 151, Guangwen Street, Kuiwen District, Weifang 261041, China. Email: doctorzhao2000@ 123456126.com ; Hui Liang. Department of Urology, People’s Hospital of Longhua Shenzhen, Southern Medical University, No. 38, Jianshe Road, Longhua, Shenzhen 518109, China. Email: dr.lianghui@ 123456aliyun.com .

Article

Publisher ID: tau-09-06-2723

DOI: 10.21037/tau-20-1458

PMC ID: 7807313

PubMed ID: 33457244

SO-VID: 56600bb6-eae8-4966-8969-81714c21c264

License:

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

Is a ureteral stent required before flexible ureteroscopy?

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Abstract

Background

Methods

Results

Conclusions

Related collections

Pan African Medical Journal

Most cited references 30

EAU Guidelines on Interventional Treatment for Urolithiasis

Epidemiology of stone disease across the world.

Urologic diseases in America project: urolithiasis.

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