BERKELEY, CA (UroToday.com) - The role for routine stenting of patients after uncomplicated ureteroscopy has been debated for many years. As detailed in the following article, many studies and meta-analyses have failed to demonstrate a significant difference in outcomes between stented and unstented patients with regard to stone-free rates, post-operative infections, and other complications. Ureteric stents are frequently poorly tolerated and result in multiple return visits to hospital.
While ureteroscopy has been demonstrated to be the most cost effective method of managing ureteric stones, one wonders if the added cost and morbidity of managing the stent post operatively mitigates these gains.[1]
A small study recently presented in South Australia focussed specifically on the effectiveness of stent education via the provision of a pamphlet on discharge, and the consequent cost savings from reducing representations.[2] By reducing the representation rate by 9%, the team were able to demonstrate a cost saving of between $899 and $1936 per case.
Indications for ureteric stent placement require further definition in order that clinical practice guidelines can be both safe and cost effective.
References:
- Lotan Y, Gettman M, Roehrborn C, Cadeddu J, Pearle M. Management of ureteral calculi: a cost comparison and decision making analysis. J Urol. 2002 Apr; 167: 1621-1629.
- Lin D, Skewes A, Singh-Rai R. Empowering patients with written information saves money. Paper presented at USANZ SA/NT Section Meeting; 17-19 Oct 2014; Adelaide, South Australia.
Written by:
Darren Foreman,a Sophie Plagakis,b and Andrew Fullerc as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
aFlinders University, Sturt Road, Bedford Park, SA 5042 Email: (corresponding author)
bRepatriation General Hospital, 216 Daws Road, Daw Park SA 5041 Email:
cRoyal Adelaide Hospital, North Terrace, Adelaide, SA 5000 Email:
Should we routinely stent after ureteropyeloscopy? - Abstract