Ahmet Y Muslumanoglu1, Sven Fuglsig2, Antonio Frattini3, Gaston Labate4, Robert B Nadler5, Alexey Martov6, Carson Wong7,8, Jean J M C H de la Rosette9. 1. 1 Department of Urology, Haseki Training and Research Hospital , Istanbul, Turkey . 2. 2 Department of Urology, University Hospital of Aarhus , Skejby, Aarhus, Denmark . 3. 3 Department of Urology, Guastalla Hospital , Reggio Emilia, Italy . 4. 4 UROSALUD, Urology Center , Buenos Aires, Argentina . 5. 5 Department of Urology, Northwestern University Feinberg School of Medicine , Chicago, Illinois. 6. 6 Department of Urology, Moscow City Hospital No 57 , Moscow, Russia . 7. 7 Division of Urology, University Hospitals Ahuja Medical Center , Beachwood, Ohio. 8. 8 Minimally Invasive and Robotic Surgery, SouthWest Urology, LLC , Cleveland, Ohio. 9. 9 Department of Urology, AMC University Hospital , Amsterdam, The Netherlands .
Abstract
PURPOSE: Double-J stent placement after stone removal by ureteroscopy (URS) is common and recommended in many cases but debatable in others. In this study, the risks and benefits of postoperative Double-J stent placement in URS stone treatment procedures undertaken in current clinical practice are examined. MATERIALS AND METHODS: The Clinical Research Office of Endourological Society (CROES) URS is a prospective, observational, international multicenter study, in which patients are candidates for URS as primary treatment or after failure of prior treatment for ureteral and renal stones. Baseline, intraoperative, and postoperative data were collected. Predictors and outcomes of postoperative stent placement were analyzed by inverse probability-weighted regression adjustment of the relationship between a Double-J stent placement and outcomes (complications, readmission [including retreatment], and length of hospital stay). RESULTS: Significant predictors of postoperative Double-J stent placement in URS treatment of ureteral stones were intraoperative complications, impacted stones, operation time, stone burden, age, presence of a solitary kidney, and stone-free rate. In renal stone treatment, the predictors identified included operation time, age, preoperative stent placement, anticoagulant use, presence of a solitary kidney, and intraoperative complications. In both ureteral and renal stone treatment groups, postoperative placement of a Double-J stent resulted in significantly fewer postoperative complications (p < 0.001) compared with patients who did not receive a stent. CONCLUSIONS: Patient- and procedure-related variables were identified, which may enable an individualized approach to postoperative stenting, resulting in improved clinical outcomes in urologic stone treatment by URS.
PURPOSE: Double-J stent placement after stone removal by ureteroscopy (URS) is common and recommended in many cases but debatable in others. In this study, the risks and benefits of postoperative Double-J stent placement in URS stone treatment procedures undertaken in current clinical practice are examined. MATERIALS AND METHODS: The Clinical Research Office of Endourological Society (CROES) URS is a prospective, observational, international multicenter study, in which patients are candidates for URS as primary treatment or after failure of prior treatment for ureteral and renal stones. Baseline, intraoperative, and postoperative data were collected. Predictors and outcomes of postoperative stent placement were analyzed by inverse probability-weighted regression adjustment of the relationship between a Double-J stent placement and outcomes (complications, readmission [including retreatment], and length of hospital stay). RESULTS: Significant predictors of postoperative Double-J stent placement in URS treatment of ureteral stones were intraoperative complications, impacted stones, operation time, stone burden, age, presence of a solitary kidney, and stone-free rate. In renal stone treatment, the predictors identified included operation time, age, preoperative stent placement, anticoagulant use, presence of a solitary kidney, and intraoperative complications. In both ureteral and renal stone treatment groups, postoperative placement of a Double-J stent resulted in significantly fewer postoperative complications (p < 0.001) compared with patients who did not receive a stent. CONCLUSIONS:Patient- and procedure-related variables were identified, which may enable an individualized approach to postoperative stenting, resulting in improved clinical outcomes in urologic stone treatment by URS.
Authors: Maria Ordonez; Eu Chang Hwang; Michael Borofsky; Caitlin J Bakker; Shreyas Gandhi; Philipp Dahm Journal: Can Urol Assoc J Date: 2019-07-23 Impact factor: 1.862
Authors: M May; M Schönthaler; C Gilfrich; I Wolff; J Peter; A Miernik; H-M Fritsche; M Burger; M Schostak; S Lebentrau Journal: Urologe A Date: 2018-02 Impact factor: 0.639
Authors: Spencer C Hiller; Stephanie Daignault-Newton; Ivan Rakic; Susan Linsell; Bronson Conrado; S Mohammad Jafri; Ronald Rubenstein; Mazen Abdelhady; C Peter Fischer; Elena Gimenez; Richard Sarle; William W Roberts; Conrad Maitland; Rafid Yousif; Robert Elgin; Laris Galejs; Jeremy Konheim; David Leavitt; Eric Stockall; J Rene Fontera; J Stuart Wolf; John M Hollingsworth; Casey A Dauw; Khurshid R Ghani Journal: Urol Pract Date: 2022-03-03