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Outcome of flexible ureteroscopy for renal stone with overnight ureteral catheterization: a propensity score-matching analysis

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Abstract

Purpose

To evaluate the influence of overnight ureteral catheterization and determine if routine long-term post-stenting can be avoided in flexible ureterorenoscopy (fURS) procedure for kidney stone.

Methods

Three hundred ninety-three patients who underwent single fURS for kidney stone between January 2013 and June 2016 at a single institute were retrospectively analyzed. The stone-free (SF) and perioperative complication rates in patients with routine long-term post-stenting after fURS (long-term stent group) were compared with those of patients with overnight ureteral catheterization (short-term stent group). Propensity score-matching analysis was used to adjust the difference in baseline preoperative parameters between the two groups. All preoperative parameters were chosen to develop the propensity score, and 74 patients in the short-term stent group were retrospectively matched with the patients in the long-term stent group at a 1:1 ratio.

Results

Patient characteristics included age, sex, side of involvement, height, body weight, body mass index, number of stone(s), stone volume, Hounsfield units of stone, preoperative white blood cell count, preoperative C-reactive protein, preoperative creatinine, pretreatment, pre-stenting, stenosis of the ureter, and procedure duration. The SF rates were 91.9 and 93.2% in the short-term and long-term stent groups, respectively. Perioperative complications were 14.9 and 12.2%. No difference was noted between the two groups in terms of SF and perioperative complication rates.

Conclusions

Short-term post-stenting using overnight ureteral catheterization in uncomplicated cases after fURS for kidney stone was as effective as conventional long-term post-stenting in reducing postoperative complications. These preliminary data suggest the possibility that routine long-term post-stenting was unnecessary.

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References

  1. Breda A, Ogunyemi O, Leppert JT, Schulam PG (2009) Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones. Eur Urol 55:1190–1197

    Article  Google Scholar 

  2. El-Nahas AR, Ibrahim HM, Youssef RF, Sheir KZ (2012) Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole stones of 10–20 mm. BJU Int 110:898–902

    Article  Google Scholar 

  3. Cohen J, Cohen S, Grasso M (2031) Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi. BJU Int 111(3 Pt B):E127–E131

    Google Scholar 

  4. Breda A, Ogunyemi O, Leppert JT, Lam JS, Schulam PG (2008) Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater—is this the new frontier? J Urol 179:981–984

    Article  Google Scholar 

  5. Pearle MS, Lingeman JE, Leveillee R, Kuo R, Preminger GM, Nadler RB et al (2008) Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol 179(Suppl):2005–2009

    Google Scholar 

  6. Papatsoris A, Sarica K (2012) Flexible ureterorenoscopic management of upper tract pathologies. Urol Res 40:639–646

    Article  Google Scholar 

  7. Takazawa R, Kitayama S, Tsujii T (2012) Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater. Int J Urol 19:264–267

    Article  Google Scholar 

  8. Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y et al (2012) The most reliable preoperative assessment of renal stone burden as a predictor of stone-free status after flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. Urology 80:524–528

    Article  Google Scholar 

  9. Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y et al (2013) Utility and limitation of cumulative stone diameter in predicting urinary stone burden at flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. PLoS One 8:8–12

    Google Scholar 

  10. Ito H, Sakamaki K, Kawahara T, Terao H, Yasuda K, Kuroda S et al (2015) Development and internal validation of a nomogram for predicting stone-free status after flexible ureteroscopy for renal stones. BJU Int 115:446–451

    Article  Google Scholar 

  11. Haleblian G, Kijvikai K, De La Rosette J, Preminger G (2008) Ureteral stenting and urinary stone management: a systematic review. J Urol 179:424–430

    Article  Google Scholar 

  12. Nabi G, Cook J, N’Dow J, McClinton S (2007) Outcomes of stenting after uncomplicated ureteroscopy: systematic review and meta-analysis. BMJ 334:572

    Article  Google Scholar 

  13. Ito H, Kawahara T, Terao H, Ogawa T, Yao M, Kubota Y et al (2012) Predictive value of attenuation coefficients measured as Hounsfield units on noncontrast computed tomography during flexible ureteroscopy with holmium laser lithotripsy: a single-center experience. J Endourol 26:1125–1130

    Article  Google Scholar 

  14. Rubenstein RA, Zhao LC, Loeb S, Shore DM, Nadler RB (2007) Prestenting improves ureteroscopic stone-free rates. J Endourol 21:1277–1280

    Article  Google Scholar 

  15. Shields JM, Bird VG, Graves R, Gómez-Marín O (2009) Impact of preoperative ureteral stenting on outcome of ureteroscopic treatment for urinary lithiasis. J Urol 182:2768–2774

    Article  Google Scholar 

  16. Jensen MP, McFarland CA (1993) Increasing the reliability and validity of pain intensity measurement in chronic pain patients. Pain 55:195–203

    Article  CAS  Google Scholar 

  17. Kanda Y (2013) Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 48:452–458

    Article  CAS  Google Scholar 

  18. Lumma PP, Schneider P, Strauss A, Plothe KD, Thelen P, Ringert RH et al (2013) Impact of ureteral stenting prior to ureterorenoscopy on stone-free rates and complications. World J Urol 31:855–859

    Article  CAS  Google Scholar 

  19. Netsch C, Knipper S, Bach T, Herrmann TRW, Gross AJ (2012) Impact of preoperative ureteral stenting on stone-free rates of ureteroscopy for nephroureterolithiasis: a matched-paired analysis of 286 patients. Urology 80:1214–1219

    Article  Google Scholar 

  20. Kawahara T, Ito H, Terao H, Ishigaki H, Ogawa T, Uemura H et al (2012) Preoperative stenting for ureteroscopic lithotripsy for a large renal stone. Int J Urol 19:881–885

    Article  Google Scholar 

  21. Zhang J, Xu C, He D, Lu Y, Hu H, Qin B et al (2016) Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis. PeerJ 4:e2728

    Article  Google Scholar 

  22. Geavlete P, Multescu R, Geavlete B (2008) Influence of pyelocaliceal anatomy on the success of flexible ureteroscopic approach. J Endourol 22:2235–2239

    Article  Google Scholar 

  23. Wong MYC (2008) Flexible ureteroscopy is the ideal choice to manage a 1.5 cm diameter lower-pole stone. J Endourol 22:1845–1846 (discussion 1859)

    Article  Google Scholar 

  24. Riley JM, Stearman L, Troxel S (2009) Retrograde ureteroscopy for renal stones larger than 2.5 cm. J Endourol 23:1395–1398

    Article  Google Scholar 

  25. Lim SH, Jeong BC, Il Seo S, Jeon SS, Han DH (2010) Treatment outcomes of retrograde intrarenal surgery for renal stones and predictive factors of stone-free. Korean J Urol 51:777–782

    Article  Google Scholar 

  26. Assimos D, Crisci A, Culkin D, Xue W, Roelofs A, Duvdevani M et al (2016) Preoperative JJ stent placement in ureteric and renal stone treatment: results from the Clinical Research Office of Endourological Society (CROES) Ureteroscopy (URS) Global Study. BJU Int 117:648–654

    Article  Google Scholar 

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Authors and Affiliations

Authors

Contributions

MK: Project development, data collection, manuscript writing. KU: Data collection. TA: Data collection. TO: Project development, manuscript editing. MT: Data analysis. KK: Data analysis. MY: Project development. JM: Project development.

Corresponding author

Correspondence to Mitsuru Komeya.

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The authors declare that they have no conflict of interest.

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For this type of study formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Komeya, M., Usui, K., Asai, T. et al. Outcome of flexible ureteroscopy for renal stone with overnight ureteral catheterization: a propensity score-matching analysis. World J Urol 36, 1871–1876 (2018). https://doi.org/10.1007/s00345-018-2328-1

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  • DOI: https://doi.org/10.1007/s00345-018-2328-1

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