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Ureteral stenting practices following routine ureteroscopy: an international survey

  • Jorge F. PereiraEmail author
  • Paul Bower
  • Eric Jung
  • Egor Parkhomenko
  • Timothy Tran
  • Simone Thavaseelan
  • Gyan Pareek
Original Article

Abstract

Purpose

Stent omission after routine ureteroscopy (rtURS) is accepted by current guidelines and may result in decreased patient morbidity and treatment costs. In a value-based healthcare model, the added morbidity and cost of routine stent placement may be scrutinized. Furthermore, data are limited on urologist cost knowledge and it is effect on ureteral stent placement. As such, we seek to describe ureteral stenting practices and urologist cost knowledge amongst US and non-US-based urologists.

Methods

The ureteroscopic practice patterns and cost awareness of members of the Endourological Society were surveyed using an international email listserv. Respondents were grouped by practice location (US vs non-US). Logistic regression was used to evaluate the associations of surgeon practice location with stenting practices.

Results

233 completed responses were received with a response rate of 13.5%. Results revealed that 55% and 71% of respondents reported ureteral stent insertion after rtURS more than 75% of the time for ureteral and renal stones, respectively. Reporting stent insertion following more than 75% of rtURS was more common among US participants for both ureteral and renal stones. Overall, reported cost knowledge was high, but lower among US participants. On multivariable analysis, US respondents were more likely to place ureteral stents after rtURS for ureteral stones more than 75% of the time when compared to those abroad (OR 3.43 p < 0.01).

Conclusion

Ureteral stenting after rtURS is over utilized in the US compared to other countries. While this phenomenon is multifactorial in nature, cost knowledge may be under recognized as a determinant of ureteral stent placement following rtURS.

Keywords

Ureteroscopy Ureteral stent Cost Practice patterns 

Abbreviations

CKS

Cost knowledge score

FSP

Frequent stent placement

IQR

Interquartile range

OR

Odds ratio

URS

Ureteroscopy

US

United States

Notes

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Columbia University Division of UrologyMount Sinai Medical CenterMiami BeachUSA
  2. 2.Warren Alpert Medical School of Brown UniversityProvidenceUSA
  3. 3.Division of UrologyRhode Island Hospital, The Miriam HospitalProvidenceUSA
  4. 4.Department of UrologyUniversity of CaliforniaIrvine, OrangeUSA
  5. 5.Minimally Invasive Urology Institute, The Miriam HospitalProvidenceUSA

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