Double-J stent placement following stone removal by URS is common and recommended in many cases but debatable in others. In this study the risks and benefits of postoperative double-J stent placement in URS stone treatment procedures undertaken in current clinical practice, are examined.
The CROES URS is a prospective, observational, international, multicentre study in which patients who were candidates for URS as primary treatment or after failure of prior treatment for ureteral stones and renal stones. Baseline, intraoperative and postoperative data were collected. Predictors and outcomes of post-operative stent placement were analysed by inverse probability weighted regression adjustment of the relationship between a Double-J stent placement and outcomes (Complications, readmission (including retreatment), and length of hospital stay) Results: Significant predictors of postoperative double-J stent placement in URS treatment of ureteral stones were intraoperative complications, impacted stones, operation time, stone burden, age, presence of a solitary kidney and stone free rate. In renal stone treatment the predictors identified included operating time, age, preoperative stent placement, anticoagulant use, presence of a solitary kidney and intraoperative complications. In both ureteral and renal stone treatment groups, postoperative placement of a double-J stent resulted in significantly fewer postoperative complications (p < 0.001) compared with patients who did not receive a stent.
Patient- and procedure-related variables were identified that may enable an individualised approach to postoperative stenting resulting in improved clinical outcomes in urological stone treatment by URS.
Journal of endourology. 2017 Mar 14 [Epub ahead of print]
Ahmet Yaser Muslumanoglu, Sven Fuglsig, Antonio Frattini, Gaston Labate, Robert B Nadler, Alexey Martov, Carson Wong, Jean J M C H de la Rosette
Haseki Education and Research Hospital, Department of Urology, istanbul, Turkey ; ., University Hospital of Aarhus , Aarhus, Denmark ; ., Hospital of Guastalla, Urology OU, Guastalla, RE, Italy ; ., Urosalud, Urology , ciudad de la paz 1596 , Buenos Aires, Argentina , 1426., Northwestern University Feinberg School of Medicine, 12244, Chicago, Illinois, United States ; ., Municipal clinical hospital #57 of Moscow, EndoUrology , 3 parkovaya, 51 , Moscow, Russian Federation , 105425 ; ., University of Oklahoma, Urology , 920 Stanton L. Young WP3150 , Oklahoma City, Oklahoma, United States , 73104 ; ., Academic Medical Center, University of Amsterdam, Urology , Meibergdreef 9 , Amsterdam, Netherlands , 1105 AZ ; .