Abstract
Objectives
Since introduction of extracorporeal shockwave lithotripsy (ESWL) in treating patients with urinary tract stones in our clinic for the first time in our city Aden 5 years ago, we stented all patients with kidney stone >1 cm routinely before the procedure.
Our aim of this study is to compare symptoms and complications of patients with and without stenting.
Patients and methods
In 2003, 120 patients with renal stone(s) amenable to ESWL management were prospectively treated in two groups: stented (60 patients) and unstented (60 patients). All patients were admitted for 48 h after ESWL and then followed for 3 months after discharge by the same treating group of doctors. Patients were followed-up radiographically to assess stone-free rate after 1 and 3 months.
Results
There was no statistical difference in flank or abdominal pain, nausea, vomiting, transient hematuria, temperature or use of analgesics on the first and second day after ESWL in the stented or unstented group. Fifty-one patients (85%) of stented group complained of side effects attributable to stent including urinary frequency and urgency, bladder pain and hematuria with urination, which in all patients but 3 of them were treated as out patient and one of the unstented group, who were readmitted because of mild to severe pain, fever, and chills. In all stented patients, we removed the stents after 2 weeks; except in readmitted patients where it was removed earlier. Plain X-ray film was done for all patients after one and 3 months. Eight patients with stents (6.7%) had >5 mm residual fragments. In these patients second ESWL session was necessary. Three months stone-free rate was 88% in stented and 91% in unstented group, respectively.
Conclusion
The use of double-J stents prior to ESWL treatment is not beneficial.
Similar content being viewed by others
References
Chaussy CH, Brendel W, Schmiedt E (1980) Extracorporeally induced destruction of kidney stones by shock waves. Lancet 2:1265–1268
Buchholz NP, Meier-Padel S, Rutishauser G (1997) Minor residual fragments after extracorporeal shock wave lithotripsy: spontaneous clearance or risk for recurrent stone formation? J Endourol 11:225–232
Jocham D, Liedl B, Lunz CH, Schuster C, Chaussy CH (1989) Langzeiterfahrungen nach SWL von Harnsteinpatienten. Urologe A 28:134–137
Kirkali Z, Esen AA, Akan G (1993) Place of double-J stents in extracorporeal shock wave lithotripsy. Eur Urol 23:460–462
Suleiman MN, Buchhloz NP, Clark PB (1999) The role of ureteral stent placement in the prevention of steinstrasse. J Endourol 13:151–155
Hollowell CMP, Patel RV, Bales GT (2000) Internet and postal survey of endourologic practice patterns among American urologists. J Urol 163:1779–1782
Chandhoke PS, Barqawi AZ, Wernrke C, Chee-Awai RA (2002) A randomized outcomes trial of ureteral stents for extracorporeal shock wave lithotripsy of solitary kidney or proximal ureteral stones. J Urol 167:1981–1983
Pryor JL, Jenkins AD (1999) Use of double-pigtail stents in extracorporeal shock wave lithotripsy. J Urol 143:475–477
Thomas R (1993) Indwelling ureteric catheter stents: impact of material and shape on patient discomfort. J Endourol 7:137–140
Dunn MD, Portis AJ, Khan SA (2000) Clinical effectiveness of new stent design: randomized single-blind comparison of tail and double-pigtail stents. J Endourol 14:195–202
Acknowledgment
My thanks to Dr. Huda Ba Saleem from the department of community medicine & public health for her help in the statistical analysis.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Musa, A.A.K. Use of double-J stents prior to extracorporeal shock wave lithotripsy is not beneficial: results of a prospective randomized study. Int Urol Nephrol 40, 19–22 (2008). https://doi.org/10.1007/s11255-006-9030-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-006-9030-8