Sahin MO. et al., 2021: Predictive Factors for Requirement of Ureteral J Stenting in Ureteroscopic Treatment of Distal Ureteral Stones.
Sahin MO, Sen V, Irer B, Yildiz G.
Manisa State Hospital, Department of Urology, Manisa, Turkey.
Izmir Metropolitan Municipality Esrefpasa Hospital, Department of Urology, Izmir, Turkey.
Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Department of Urology, Izmir, Turkey.
Background: We aimed to investigate the factors predicting the need for ureteral J stent placement in the treatment of distal ureteral stones by ureteroscopy (URS).
Methods: Between January 2007 and June 2018, 550 consecutive patients who underwent URS with the diagnosis of distal ureteral stone disease were evaluated in a single center. The patients were divided into two groups as; group 1 who received a ureteral J stent, and group 2 without ureteral J stent. The two groups were compared in terms of possible preoperative, perioperative and postoperative risk factors.
Results: History of systemic disease, stone disease and extracorporeal shock wave lithotripsy (SWL) were significantly higher in group 1 (P<0.001, P=0.009, P=0.016). The operation time was longer in group 1 (P<0.001). The rate of impacted stones was higher in group 1 (61.7% vs 15.6%; P<0.001). In multivariate analysis, co-morbidities, previous SWL history, presence of impacted ureteral stone and prolongation of the operation time were found to be statistically significant in predicting ureteral J stent placement.
Conclusion: In the treatment of distal ureteral stones by URS, not only perioperative complications, prolongation of the operation time, and the presence of residual stones but also preoperative factors, such as systemic disease, and impacted ureteral stones should be considered as predictive factors in assessing the need for a ureteral J stent and to avoid unnecessary stent procedures.
Arch Iran Med. 2021 Jul 1;24(7):542-547. doi: 10.34172/aim.2021.77. PMID: 34488319
ESWL in the medical history of the patients is only mentioned as one of the multiple factors that showed a correlation to post-URS stenting. It is not indicated if these cases were failures of ESWL for the same stone.
In the abstract, a previous ESWL is said to correlate statistically significant to stent placement in the multivariate analysis. However, in the text the risk of stenting after previous ESWL was high (OR:2.80) but not significantly 0.063 different.