World Journal of Urology

, Volume 28, Issue 3, pp 373–378 | Cite as

Insertion of double J stent as a therapeutic test in management of adults presenting with loin pain and equivocal ureteropelvic junction obstruction

  • Tarek Osman
  • Khaled Fawaz
  • Alaa Abdelmaksoud
  • Ihab Eltahawy
  • Wael Safa
  • Tarek El Zayat
  • Dahlia El Sadek
  • Rafik El Halaby
Original Article
First Online:
Received:
Accepted:

Abstract

Purpose

To evaluate temporary double J ureteric stenting (TDJS) as a test to diagnose ureteropelvic junction obstruction (UPJO) in equivocal cases.

Materials and methods

One hundred and nine consecutive adult patients with loin pain and ipsilateral equivocal UPJO (EqUPJO) on radioisotope diuretic renogram (RDR) were enrolled in the present study. All patients underwent TDJS for 3 weeks. According to the response (relief of pain) to TDJS, which was assessed by visual analogue pain score (VAPS), patient preference and further management, patients were classified into five groups: Group Ia non-responders who elected conservative treatment for their condition, Group Ib non-responders who elected intervention, Group IIa responders who elected conservative treatment and Group IIb responders who elected intervention. Last group patients were randomized to either early (Group IIb1) or delayed intervention 3 months later (Group IIb2). Intervention was in the form of pyeloplasty (24 patients) and endopyelotomy (38 patients). All patients were followed up by measuring VAPS and RDR.

Results

After at least 6 months from management decision, 97 patients were available for evaluation. The VAPS dropped by 21.25% (P < 0.001), 32% (P = 0.004), 2% (P = 0.6), 54% (P < 0.001) and 65% (P < 0.001) in groups Ia, Ib, IIa, IIb1, and IIb2, respectively. On the other hand the T 1/2 of RDR dropped significantly only in groups Ib, IIb1, and IIb2 by a mean of 6.5 min (P = 0.005), 8.02 min (P < 0.001), and 7.3 min (P < 0.001), respectively.

Conclusion

TDJS in cases of EqUPJO with loin pain is helpful in defining cases suitable for intervention versus conservative treatment.

Keywords

Ureteral obstruction Imaging Obstruction 
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Notes

Conflict of interest statement

The authors have no conflict of interest with any institution or product that is mentioned in the manuscript and/or is important to the outcome of the study presented.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Tarek Osman
    • 1
    • 3
  • Khaled Fawaz
    • 1
  • Alaa Abdelmaksoud
    • 1
  • Ihab Eltahawy
    • 1
  • Wael Safa
    • 1
  • Tarek El Zayat
    • 1
  • Dahlia El Sadek
    • 2
  • Rafik El Halaby
    • 1
  1. 1.Urology DepartmentAin Shams UniversityCairoEgypt
  2. 2.Radiology DepartmentEgypt Air HospitalCairoEgypt
  3. 3.CairoEgypt

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