Nonstented versus routine stented ureteroscopic ho

Authors: Yi Shao Jian Zhuo XiaoWen Sun Wei Wen HaiTao Liu ShuJie Xia

Publish Date: 2008/09/17

Volume: 36, Issue: 5, Pages: 259-

PDF Link

Abstract

We conducted a prospective randomized study to evaluate whether postoperative ureteral stenting is necessary after ureteroscopic holmium laser lithotripsy A total of 115 consecutive patients with distal or middle ureteral calculi amenable to ureteroscopic holmium laser lithotripsy were prospectively randomized into stented group n = 58 and nonstented group n = 57 The stent was routinely placed in the treated ureter for 2 weeks The outcomes were measured with postoperative patient symptoms stonefree rates early and late postoperative complications and costeffectiveness The postoperative symptoms were measured with Ureteral Stent Symptom Questionnaire USSQ All patients completed a 12week followup There was no significant difference between two groups with respect to the patient age stone size stone location and mean operative time According to the USSQ the symptoms of the stented group were significantly worse compared to the nonstented group P = 00001 In the stented group two patients had high fever for 1 week after the operation stent migration was found in two patients and the stents had to be removed earlier in five patients because of severe pain or hematuria The cost of the stented group was significantly higher than the nonstented group The stonefree rate was 100 in both groups No hydronephrosis or ureteral stricture was detected by intravenous pyelogram in the 12th week postoperative followup In conclsion we believe that routine stenting after ureteroscopic intracorporeal lithotripsy with the holmium laser is not necessary as long as the procedure is uncomplicated for distal or middle ureteral calculis less than 2 cm

Keywords: