A Stent for Every Stone? Prestenting Habits and Outcomes from a German Multicenter Prospective Study on the Benchmarks of Ureteroroscopic Stone Treatment (BUSTER).

Previous studies have shown that prestenting in ureterorenoscopic stone removal (URS) is carried out more frequently in Germany than in other countries.

This investigation evaluated the impact of high prestenting rates on outcomes as well as the influence of stone characteristics and treatment habits on prestenting.

The dataset from the BUSTER observational study was used. Patient and stone characteristics, as well as treatment outcomes, were analyzed for 307 cases from 14 urological clinics in Germany.

The overall prestenting rate was 70.0%. Prestenting rates were significantly higher for renal stones than ureteric stones (84.6 vs. 60.6%, p < 0.0001). Compared to the unstented cases, prestenting for renal stones improved stone-free rates (73.2 vs. 11.1%, p < 0.0001) and increased the rate of completely lesion-free URS (45.4 vs. 16.7%, p = 0.034) while reducing the rate of poststenting (from 100 to 80.8%, p = 0.041). None of these effects could be demonstrated when prestenting for ureteric stones. Prestenting rates were less variable for renal stones (57-100%) than for ureteric stones (0-100%, p < 0.01).

This study confirms the benefits of prestenting in URS for renal stones but not for ureteric stones. There were considerable differences in prestenting rates between the participating clinics.

Urologia internationalis. 2020 Jan 24 [Epub ahead of print]

Peter Werthemann, Steffen Weikert, Thomas Enzmann, Martin Schostak, Steffen Lebentrau

Department of Urology, Vivantes Humboldt Klinikum, Berlin, Germany, ., Department of Urology, Vivantes Humboldt Klinikum, Berlin, Germany., Department of Urology and Pediatric Urology, St├Ądtisches Klinikum Brandenburg, Brandenburg an der Havel, Germany., Department of Urology and Pediatric Urology, Universit├Ąt Otto von Guericke, Magdeburg, Germany., Department of Urology and Pediatric Urology, Ruppiner Kliniken, Neuruppin, Germany.

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