Skip to main content
SpringerLink
Log in

Is routine ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy for lower ureteral stones larger than 1 cm?

  • Original Paper
  • Published:
Urological Research Aims and scope Submit manuscript

An Erratum to this article was published on 29 April 2008

Abstract

We evaluated the need for routine ureteral stenting after uncomplicated ureteroscopic lithotripsy (URSL) without dilation for lower ureteral stones larger than 1 cm. A total of 43 patients underwent URSL for lower ureteral stones larger than 10 mm. They were randomized into a stented (21) or an unstented (22) group. URSL was performed by using a semirigid ureteroscope and pneumatic lithotripter without ureteral dilation. Additional forceps application (AFA) was used to remove fragments ≥4 mm. Patients in each group were assessed for stone-free rate, stone size, operative time, AFA, hospitalization time, postoperative pain, irritative voiding symptoms, hematuria, re-hospitalization and stricture formation. The stone-free rate was 100% in each group. There were no statistical differences in the two groups regarding stone size, operative time, AFA, postoperative pain, hematuria and hospitalization time. However, irritative voiding symptoms of the stented group were significantly higher than those in the unstented group (P < 0.05). One patient (4.5%) in the unstented group required re-hospitalization for severe flank pain with fever (>38°C) compared to one patient (4.7%) in the stented group for proximal stent migration (P > 0.05). Stricture formation was not demonstrated in either group at 3 months follow-up excretory urography (EXU). Our results demonstrate that ureteral stenting after uncomplicated URSL without dilation for lower ureteral stones larger than 1 cm does not appear to be necessary if AFA is used to remove fragments ≥4 mm, thereby reducing morbidity of patients and risk of re-hospitalization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Matthew T, Gettman MT, Segura JW (2005) Management of ureteric stones: issues and controversies. BJU Int 95:85–93

    Article  Google Scholar 

  2. Knudsen BE, Beiko DT, Denstedt JD (2004) Stenting after ureteroscopy: pros and cons. Urol Clin North Am 31:173–180

    Article  PubMed  Google Scholar 

  3. Pollard SG, MacFarlane R (1988) Symptoms arising from double-J ureteral stents. J Urol 139:37–38

    CAS  PubMed  Google Scholar 

  4. El-Faqih SR, Shamsuddin AB, Chakrabarti A, Atassi R, Kardar AH, Osman MK (1991) Polyurethane internal ureteral stents in the treatment of stone patients: morbidity related to indwelling times. J Urol 146:1487–1491

    CAS  PubMed  Google Scholar 

  5. Netto NR Jr, Ikonomidis J, Zillo C (2001) Routine ureteral stenting after ureteroscopy for ureteral lithiasis: is it really necessary? J Urol 166:1252–1254

    Article  PubMed  Google Scholar 

  6. Damiano R, Autorino R, Esposito C, Cantiello F, Sacco R, Sio de M (2004) Stent positioning after ureteroscopy for urinary calculi: the question is still open. Eur Urol 46:381–387

    Article  PubMed  Google Scholar 

  7. Jeong H, Kwak C, Lee SE (2004) Ureteric stenting after ureteroscopy for ureteric stones: a prospective randomized study assessing symptoms and complications. BJU Int 93:1032–1034

    Article  CAS  PubMed  Google Scholar 

  8. Denstedt JD, Wollin TA, Sofer M, Nott L, Weir M, Honey RJ D’A (2001) A prospective randomized controlled trial comparing nonstented versus stented ureteroscopic lithotripsy. J Urol 165:1419–1422

    Article  CAS  PubMed  Google Scholar 

  9. Borboroglu PG, Amling CL, Schenkman NS, Monga M, Ward JF, Piper NY (2001) Ureteral stenting after ureteroscopy for distal ureteral calculi: a multi-institutional prospective randomized controlled study assessing pain, out-comes and complications. J Urol 166:1651–1657

    Article  CAS  PubMed  Google Scholar 

  10. Bryne RR, Auge BK, Kourambas J, Munver R, Delvecchio F, Preminger GM (2002) Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy: a randomized trial. J Endourol 16:9–13

    Article  Google Scholar 

  11. Srivastava A, Gupta R, Kumar A, Kapoor R, Mandhani A (2003) Routine stenting after ureteroscopy for distal ureteral calculi is unnecessary: results of a randomized controlled trial. J Endourol 17:871–874

    Article  PubMed  Google Scholar 

  12. Ramsay JW, Payne SR, Gosling PT, Whitfield HN, Wickman JE, Levion DA (1985) The effect of double j stenting on unobstructed ureters. An experimental and clinical study. Br J Urol 57:630–634

    Article  CAS  PubMed  Google Scholar 

  13. Fine H, Gordan RL, Lebensart PD (1989) Extracorporeal shock wave lithotripsy and stents: flouroscopic observation and a hypothesis on the mechanism of stent function. Urol Radiol 11:37–41

    Article  CAS  PubMed  Google Scholar 

  14. Ryan PC, Lennon GM, McLean PA, Fitzpatrick JM (1994) The effects of acute and chronic JJ stent placement on upper urinary tract motility and calculus transit. Br J Urol 74:434–439

    Article  CAS  PubMed  Google Scholar 

  15. Bierkens AF, Hendrikx AJM, Lemmens WAJ, Debruyne FM (1991) Extracorporeal shock wave lithotripsy for large renal calculi: the role of ureteral stents. A randomized trial. J Urol 145:699–702

    CAS  PubMed  Google Scholar 

  16. Kupeli B, Alkibay T, Sınık Z, Karaoglan U, Bozkırlı I (2000) What is the optimal treatment for lower ureteral stones larger than 1 cm? Int J Urol 7:167–171

    Article  CAS  PubMed  Google Scholar 

  17. Yagisawa T, Kobayashi C, Ishikawa N, Kobayashi H, Toma H (2001) Benefits of ureteroscopic pneumatic lithotripsy for the treatment of impacted ureteral stones. J Endourol 15:697–699

    Article  CAS  PubMed  Google Scholar 

  18. Joshi HB, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG, Barry MJ (2003) Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol 169:1065–1069

    Article  CAS  PubMed  Google Scholar 

  19. Teichman JMH, Vassar GJ, Bishoff JT, Bellman GC (1998) Holmium YAG lithotripsy yields smaller fragments than lithoclast, pulsed dye laser or electrohydraulic lithotripsy. J Urol 159:17–23

    Article  CAS  PubMed  Google Scholar 

  20. Kauer PC, Laguna MP, Alivizatos G, Joyce A, Muschter R, Swartz R, Tolley D, De La Rosette JMCH (2005) Present practice and treatment strategies in endourological stone management: results of a survey of the European Society of Uro-technology (ESUT). Eur Urol 48:182–188

    Article  CAS  PubMed  Google Scholar 

  21. Kupeli B, Biri H, Isen K, Onaran M, Alkibay T, Karaoglan U (1998) Treatment of ureteral stones: comparison of extracorporeal shock wave lithotripsy and endourologic alternatives. Eur Urol 34:474–479

    Article  CAS  PubMed  Google Scholar 

  22. Keeley FX Jr, Pıllaı M, Smith G, Chrissofos M, Tolley DA (1999) Electrokinetik lithotripsy: safety, efficacy and limitations of a new form of ballistic lithotripsy. BJU Int 84:261–263

    Article  PubMed  Google Scholar 

  23. Harmon WJ, Sershon PD, Blute ML, Patterson DE, Segura JW (1997) Ureteroscopy: current practice and long-term complications. J Urol 157:28–32

    Article  CAS  PubMed  Google Scholar 

  24. Krambeck AE, Murat FJ, Gettman MT, Chow GK, Patterson DE, Segura JW (2006) The evolution of ureteroscopy: a modern single-institution series. Mayo Clin Proc 81:468–473

    Article  PubMed  Google Scholar 

  25. Roberts WW, Cadeddu JA, Micali S, Kavoussi LR, Moore RG (1998) Ureteral stricture formation after removal of impacted calculi. J Urol 159:723–726

    Article  CAS  PubMed  Google Scholar 

  26. Dretler SP, Young RH (1993) Stone granuloma: a cause of ureteral stricture. J Urol 150:1800–1802

    CAS  PubMed  Google Scholar 

  27. Netto Junior NR, Claro JA, Esteves SC, Andrade EF (1997) Ureteroscopic stone removal in the distal ureter. Why change? J Urol 157:2081–2083

    Article  CAS  PubMed  Google Scholar 

  28. Chen YT, Chen J, Wong WY, Yang SS, Hsieh CH, Wang CC (2002) Is ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy? A prospective, randomized controlled trial. J Urol 167:1977–1980

    Article  PubMed  Google Scholar 

  29. Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck C, Gallucci M, Knoll T, Lingeman JE, Nakada SY, Pearle MS, Sarıca K, Türk C, Wolf JS Jr (2007) EAU/AUA Nephrolithiasis Guideline Panel. 2007 guideline for the management of ureteral calculi. J Urol 178:2418–2434

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinic of Urology, State Hospital of Diyarbakir, Ofis cami sok, Ayyildiz Apt., Kat: 5 No:15, 2100, Diyarbakir, Turkey

    Isen Kenan, Bogatekin Salih, Em Suat, Ergin Huseyin & Kilic Vehbi

Authors
  1. Isen Kenan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bogatekin Salih
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Em Suat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ergin Huseyin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kilic Vehbi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Isen Kenan.

Additional information

An Erratum for this article can be found at http://dx.doi.org/10.1007/s00240-008-0136-6

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kenan, I., Salih, B., Suat, E. et al. Is routine ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy for lower ureteral stones larger than 1 cm?. Urol Res 36, 115–119 (2008). https://doi.org/10.1007/s00240-008-0135-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-008-0135-7

Keywords

Search

Navigation