Ureteral stenting with extracorporeal shock-wave lithotripsy.
We reviewed the results of ureteral stent use with extracorporeal shock-wave lithotripsy (ESWL) in 3,096 patients with renal calculi less than 3 cm in diameter. The 2,595 patients with indwelling ureteral stents required lower total power (shocks x voltage) and less radiation and had a lower secondary procedure rate but a higher retreatment rate than the 501 patients without stents. However, the only statistically significant difference was in the average radiation dose in patients with or without stents and single stones no larger than 10 mm (16 vs. 18 rad). The hospital stay was one day or less in 98 percent of the patients in both groups. With an 80 percent follow-up rate at three months indwelling ureteral stents were associated with a higher stone-free rate in patients with a single stone but a lower stone-free rate in patients with multiple stones, compared with those treated without a stent. An indwelling ureteral stent may result in urinary frequency and bladder discomfort in some patients, and with no statistical difference in the results with or without a ureteral stent it is questionable whether or not the high use of an indwelling ureteral stent is justified in patients admitted for one day or less.
Cass
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Midwest Urologic Stone Unit, Hennepin County Medical Center, Minneapolis, Minnesota.
D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D011829:Radiation Dosage; D012008:Recurrence; D015607:Stents; D014546:Urinary Catheterization