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The role of stenting in relieving loin pain following ureteroscopic stone therapy for persisting renal colic with hydronephrosis

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Abstract

Objective To prospectively define the role of the double J-stent placement following ureteroscopic stone therapy in providing a pain-free postoperative period for patients with persisting loin pain and documented hydronphrosis. Material and methods The study cohort consisted of 27 patients (mean age: 38.59 years; range: 22–60 years) who had undergone ureteroscopic intervention due to ureteral stone. All of the patients reported loin pain which did not respond to medical therapy associated with various degrees of hydronephrosis documented by ultrasound and/or an excretory urogram. The patients were randomized to either a stented (18 patients) or stentless (nine patients) group following semirigid ureteroscopy (7.5/12 Fr) for the treatment of ureteral calculi (pneumatic lithotripsy). The mean diameter of the stones was 7.7 mm (range: 3–13 mm). Intra-operative balloon ureter orifice dilatation was routinely performed. All patients were evaluated between 0 and 6 days postoperative for loin pain and lower urinary tract symptoms. Results Nine patients had loin pain in the first few days following the operation and were in need of intramuscular and/or intravenous analgesics. Of these, four were stented patients (4/18; 22.2%) and five were stentless patients (5/9; 55.5%). Lower urinary tract symptoms were not clinically significant and did not affect the quality of life in terms of loin pain, with the exception of one patient in whom the stent had dropped into the bladder. Conclusion We believe that stenting in patients with documented hydronephrosis manifesting in persisting renal colic is recommended. As ureteroscopic therapy may aggregate the edema of ureter mucosa, double J-stent placement may play an important role in offering patients a postoperative period free of loin discomfort. However, further prospective trials should be designed to evaluate the criteria for stentless ureterorenoscopy.

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References

  1. Tawfik ER, Bagley DH Management of upper urinary tract calculi with ureteroscopic techniques Urology 1999; 53:25

    Article  Google Scholar 

  2. Harmon WJ, Sershon PD, Blute ML, et al. Ureteroscopy: current practice and long term complication J Urol 1997; 157:28

    Article  PubMed  CAS  Google Scholar 

  3. Hosking DH, McColm SE, Smith WE, Smith WE Is stenting following ureteroscopy for removal of distal ureteral calculi necessary? J Urol 1999; 139:37

    Google Scholar 

  4. Rane A, Cahill D, Larner T, Saleemi A et al. To stent or not to stent? That is still question J Endourol 2000; 14:479

    Article  PubMed  CAS  Google Scholar 

  5. Cheung MC, Yip SK, Lee FC, Tam PC Outpatient ureteroscopic lithotripsy: selective internal stenting and factor enhancing success J Endourol 2000: 14:559

    Article  PubMed  CAS  Google Scholar 

  6. Hollenbeck BK, Schuster TG, Faerber GJ, Wolf JS, Jr Routine placement of ureteral stent is unnecessary after ureteroscopy for urinary calculi Urology 2001; 57:639

    Article  PubMed  CAS  Google Scholar 

  7. Blute ML, Segura JW, Patterson DE Ureteroscopy J Urol 1999; 139:510

    Google Scholar 

  8. Dertler SP An evaluation of ureteral laser lithotripsy: 225 consecutive patients J Urol 1990; 143:267

    Google Scholar 

  9. Bagley DH Removal of upper urinary tract calculi with flexible ureteropyeloscopy Urology 1990; 35:412

    Article  PubMed  CAS  Google Scholar 

  10. Stoller ML, Wolf JS, Jr, Hofman R, Marc B Ureteroscopy without routine balloon dilation dilatation : an outcome assessment J Urol 1992; 147:1238

    PubMed  CAS  Google Scholar 

  11. Cheung MC, Lee F, Leung YL, Wong. BB et al. Out patient ureteroscopy: predictive factors for postoperative events Urology 2001; 58:914

    Article  PubMed  CAS  Google Scholar 

  12. Boddy SA, Nimmon CC, Jones S, Ramsay JW et al. Acute ureteric dilatation for ureteroscopy. An experimental study Br J Urol 1988; 61:27

    PubMed  CAS  Google Scholar 

  13. Netto NR, Jr, Ilkonomidis J, Zillo C Routine uretral stenting after ureteroscopy for uretral lithiasis: is it really necessary? J Urol 2001; 166:1252

    Article  PubMed  Google Scholar 

  14. Chen YY, Chen J, Wong WY, Yang SSD et al. Is ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy? A prospective, randomized controlled trial J Urol 2002; 167:1977

    Article  PubMed  Google Scholar 

  15. Denstedt JD, Wollin TA, Sofer M, Nott L et al. A prospective randomized controlled trial comparing nonstented vs. stented uretroscopic lithotripsy J Urol 2001; 165:1419

    Article  PubMed  CAS  Google Scholar 

  16. Brent KH, Timothy GS, Brian DS, Gary JF et al. Identifying patients who suitable for stentless ureteroscopy following treatment of urolithiasis J Urol 2003; 170:103–106

    Article  Google Scholar 

  17. Borboroglu PG, Amling CL, Schenkman NS, Monga M et al. Ureteral stenting after ureteroscopy for distal ureter calculi: multiple-institutional prospective randomized controlled study assessing pain out-come complications J Urol 2001; 166:1651

    Article  PubMed  CAS  Google Scholar 

  18. Mydlo JH, Streater S The applicability of using straight ureteral stents for treatment ureteral stone in presumably non-compliant patients Urol Int 2001; 66:201–4

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Mahmoud Mustafa.

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Mustafa, M. The role of stenting in relieving loin pain following ureteroscopic stone therapy for persisting renal colic with hydronephrosis. Int Urol Nephrol 39, 91–94 (2007). https://doi.org/10.1007/s11255-005-4976-5

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  • DOI: https://doi.org/10.1007/s11255-005-4976-5

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