Summary
The effect of preoperative Double-J (DJ) ureteral stenting before flexible ureterorenoscopy (FURS) in the treatment for urinary stones was evaluated. We retrospectively enrolled 306 consecutive patients who underwent FURS from Jan. 2014 to Dec. 2017. All the patients were classified into two groups according to whether they had DJ ureteral stenting before FURS. Baseline characteristics (age, sex, stone location, stone size, surgical success rate, operation time, stone-free rate of the first day after surgery, stone-free rate of the first month after surgery, total complication rate) were compared using Chi-square test for categorical variables and Kruskal-Wallis test for continuous variables. In total, 306 patients were included in this study. The group of DJ stenting before FURS included 203 (66.3%) patients, and non-DJ stenting before FURS was observed in 103 (33.7%) patients. The group of DJ stenting before FURS was significantly associated with a shorter operation time (53.8 vs. 59.3 min, P<0.001), a higher stone-free rate of the first day after surgery (69.0% vs. 51.5%, P=0.003). However, statistical significant differences were not found in the age, sex, stone location, stone size, surgical success rate, stone-free rate of the first month after surgery (89.2% vs. 81.6%, P=0.065) and total complication rate (5.4% vs. 9.7%, P=0.161) between the two groups. Preoperative DJ ureteral stenting before FURS could reduce the operation time and increase stone-free rate of the first day after surgery. However, it might not benefit the stone-free rate of the first month after surgery and reduce the complication rate. Preoperative DJ stenting should be not routinely performed.
Similar content being viewed by others
References
Goodman TM. Ureteroscopy with pediatric cystoscope in adults. Urology, 1977,9(4):394
Netsch C, Knipper AS, Orywal AK, et al. Impact of surgical experience on stone-free rates of ureteroscopy for single urinary calculi of the upper urinary tract: a matched-paired analysis of 600 patients. J Endourol, 2015,29(1):78–83
Schoenthaler M, Wilhelm K, Hein S, et al. Ultra-mini PCNL versus flexible ureteroscopy: a matched analysis of treatment costs (endoscopes and disposables) in patients with renal stones 10–20 mm. World J Urol, 2015,33(10):1601–1605
Chander J, Dangi AD, Gupta N, et al. Evaluation of the role of preoperative Double-J ureteral stenting in retroperitoneal laparoscopic pyelolithotomy. Surg Endosc, 2010,24(7):1722–1726
Lumma PP, Schneider P, Strauss A, et al. Impact of ureteral stenting prior to ureterorenoscopy on stone-free rates and complications. World J Urol, 2013,31(4):855–859
Giusti G, Proietti S, Luciani LG, et al. Is retrograde intrarenal surgery for the treatment of renal stones with diameters exceeding 2 cm still a hazard? Can J Urol, 2014,21(2):7207–7212
Hamamoto S, Yasui T, Okada A, et al. Endoscopic combined intrarenal surgery for large calculi: simultaneous use of flexible ureteroscopy and mini-percutaneous nephrolithotomy overcomes the disadvantageous of percutaneous nephrolithotomy monotherapy. J Endourol, 2014,28(1):28–33
Al-Qahtani SM, Letendre J, Thomas A, et al. Which ureteral access sheath is compatible with your flexible ureteroscope? J Endourol, 2014,28(3):286–290
Traxer O, Thomas A. Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol, 2013,189(2):580–584
Ding J, Huang Y, Gu S, et al. Flexible Ureteroscopic Management of Horseshoe Kidney Renal Calculi. Int Braz J Urol, 2015,41(4):683–689
Fan S, Gong B, Hao Z, et al. Risk factors of infectious complications following flexible ureteroscope with a holmium laser: a retrospective study. Int J Clin Exp Med, 2015,8(7):11252–11259
Newman RC, Hunter PT, Hawkins IF, et al. A general ureteral dilator-sheathing system. Urology, 1985, 25(3): 287–288
Monga M, Bhayani S, Landman J, et al. Ureteral access for upper urinary tract disease: the access sheath. J Endourol, 2001,15(8):831–834
Turk C, Petrik A, Sarica K, et al. European Association of Urology Guidelines on urolithiasis. 2017.
Cetti RJ, Biers S, Keoghane SR. The difficult ureter: what is the incidence of pre-stenting? Ann R Coll Surg Engl, 2011,93(1):31–33
Schuster TG, Hollenbeck BK, Faerber GJ, et al. Ureteroscopic treatment of lower pole calculi: comparison of lithotripsy in situ and after displacement. J Urol, 2002,168(1):43–45
Shields JM, Bird VG, Graves R, et al. Impact of preoperative ureteral stenting on outcome of ureteroscopic treatment for urinary lithiasis. J Urol, 2009,182(6):2768–2774
Mogilevkin Y, Sofer M, Margel D, et al. Predicting an effective ureteral access sheath insertion: a bicenter prospective study. J Endourol, 2014,28(12):1414–1417
Berquet G, Prunel P, Verhoest G, et al. The use of a ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones. World J Urol, 2014,32(1):229–232
Ayyathurai R, Kanagarajah P, Shields J, et al. Singlecenter clinical comparison of two reinforced ureteral access sheaths for retrograde ureteroscopic treatment of urinary lithiasis. Int Urol Nephrol, 2012,44(2):409–414
Torricelli FC, De S, Hinck B, et al. Flexible ureteroscopy with a ureteral access sheath: when to stent? Urology, 2014,83(2):278–281
Hyams ES, Monga M, Pearle MS, et al. A prospective, multi-institutional study of flexible ureteroscopy for proximal ureteral stones smaller than 2 cm. J Urol, 2015,193(1):165–169
Author information
Authors and Affiliations
Corresponding author
Additional information
This study was supported by the Natural Science Foundation of Fujian (No. 2017D0010), Young and Middle-aged Backbone Talents Training Project of Fujian (No. 2017-ZQN-81) and the National Natural Science Foundation of China (No. 81970604).
Conflict of Interest Statement
All authors declare that they have no conflicts of interest.
Rights and permissions
About this article
Cite this article
Bai, Pd., Wang, T., Huang, Hc. et al. Effect of Preoperative Double-J Ureteral Stenting before Flexible Ureterorenoscopy on Stone-free Rates and Complications. CURR MED SCI 41, 140–144 (2021). https://doi.org/10.1007/s11596-021-2328-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11596-021-2328-z