International collaboration in Endourology (UROICE): Multicenter evaluation of prestenting for ureterorenoscopy

INTRODUCTION - Semirigid and flexible ureterorenoscopy (URS) are safe and efficient treatment options for urolithiasis of all localizations. Sometimes, a JJ-stent is placed in preparation of definitive treatment. Aim of our study was to evaluate the influence of prestenting on the outcome of URS.

METHODS - We retrospectively analyzed 565 patients out of our prospective multicenter, multinational database who underwent URS for renal or ureteral stones from 06/2011 to 12/2013. Demographic and stone related data, surgery time, stone clearance and complications were evaluated. Statistical analysis was performed comparing the prestented and nonstented group.

RESULTS - Demographic data, stone size and localization were comparable in both groups. 323 patients were prestented and 242 nonstented. Overall, prestenting had significant influence on stone free rate (86% prestented vs 74% not-prestented, p=0. 0003) and complication rate (6. 5% vs 14. 5%, p=0. 003) but not on surgery-time (55±36 vs 61±35 min, p=0. 071). Subgrouped, this was also true for renal stones (83% vs 60%, p=0. 0001, OR 3. 15 [CI 1. 77-5. 62] / 8. 7% vs 19. 4%, p=0. 02, 0. 39 [CI 0. 19-0. 83] ). For ureteral stones, there was no significant influence on stone free rate (94% vs 90%, p=0. 4, OR 1. 63 [CI 0. 63 - 4. 22]), but significantly more complications (3. 1% vs 10. 7%, p=0. 02, OR 0. 27 [CI 0. 08-0. 86]) in the non-stented group.

CONCLUSIONS - Prestenting positively affects safety and efficacy of URS. This is more pronounced in the treatment of kidney stones compared with ureteral stones. Although the stone free rate for ureteral stones is comparable without prestenting, the complication rate is higher.

Journal of endourology / Endourological Society. 2015 Nov 19 [Epub ahead of print]

Jan Peter Jessen, Alberto Breda, Marianne Brehmer, Evangelos N Liatsikos, Felix Millan, Palle Joern Sloth Osther, Cesare Scoffone, Thomas Knoll

Klinikum Sindelfingen-Boeblingen, University of Tuebingen, Department of Urology, Sindelfingen, Germany, Fundacio Puigvert, Department of Urology, Barcelona, Spain, Karolinska University , Stockholm, Sweden. , University of Patras, Department of Urology, ATHENS, Greece, Fundacio Puigvert, Department of Urology, Barcelona, Spain, Lillebaelt Hospital, University of Southern Denmark, Department of Urology, Fredericia, Denmark, Cottolengo Hospital, Department of Urology, Torino, Italy, Klinikum Sindelfingen-Boeblingen, Department of Urology , University of Tuebingen , Arthur-Gruber-Str. 70 , Sindelfingen, Germany , 71065 , 49 7031 98-12501 , 49 7031 815307.