Login to Access Video or Poster Abstract: MP68-01
Sources of Funding: none

Introduction

Currently, only a few studies investigate the effects of ureteral stenting (JJ catheter) prior to ureteroscopy (URS). This retrospective single-center study is intended to demonstrate the role of preoperative ureter stenting in ureteroscopy in treatment for ureteral stones and to compare the stone-free rate (SFR) and therapy-associated complications of the primary URS to the URS after ureter stenting

Methods

We retrospectively evaluated 197 URS in our clinic from 2014 to 2015. The patients were classified into two groups, depending on whether they had a stent placed before URS. 46 patients undergo primary URS and 151 URS were pre-stented prior to URS. The intra- and postoperative results were analyzed with complications as well as stone-free rates depending on treatment details according to adapted Clavien-Dindo classification. We investigate the retrospective data from patient records, imaging and surgical reports

Results

73% of the patients were pre-stented before URS, compared to 24% which were treated primarily ureteroscopically. The mean operation time in the pre-stented group was slightly longer (27.7 vs. 27.2 min). The totally stone-free rate (SFR) of the pre-stented patients was 81%, compared with 94% without preoperative stenting. The rate of minor intraoperative complications was 4.6% for pre-stented patients versus 2% without stent (adapted for Clavien-Dindo I-II classification). Major complications of the IIIb-V degree were not observed in both groups. The intraoperative complication of the primary URS group consisted of perforation of the ureter. The intraoperative complications of the pre-stented URS group consisted of 57% ureteral lesion and 43% of slight bleeding. The rate of postoperative complications was 12% for pre-stenting group versus 6.5% without stent. The postoperative complications for the primary URS group consisted of 100% of urinary tract infections. The postoperative complications for the secondary URS group consist of urinary tract infections 53% and hydronephrosis 47%

Conclusions

Ureteroscopic stone extraction resulted in good stone-free rates with low morbidity. Ureteral stenting before URS does not improve the stone-free rate. The few ureteral lesions could be treated without consequences by urethral stenting. The most of postoperative complications consisted of urinary tract infections and hydronephrosis. Limitations of the study include short follow-up and non-standardized treatment approach. The highest incidence of postoperative complications occurred at stone size larger from 7-8 mm.

Funding

none