Impact of preoperative ureteral stenting on stone-free rates of ureteroscopy for nephroureterolithiasis: a matched-paired analysis of 286 patients.
OBJECTIVE
To determine the effect of preoperative ureteral stenting on success rates of ureteroscopy (URS) for nephroureterolithiasis.


METHODS
We retrospectively evaluated patients who underwent URS for nephroureterolithiasis without preoperative indwelling ureteral stents. These patients were matched according to age, sex, body mass index, and stone side, size, site, and number of stones per patient, with patients who had been prestented before URS. Patient data, stone-free rates (SFRs), and complications were compared.


RESULTS
The study included 286 patients (143 stented vs 143 nonstented). The mean stone size was 5.69 ± 3 mm. The mean number of stones per patient was 1.35 ± 0.7. The overall SFR after 1 URS procedure was 90.9% and higher in prestented than in nonstented patients (95.1% vs 86.7%, P ≤ .013). For ureteral stones, the SFR was 99% in prestented and 90% in nonstented patients (P ≤ .0048). The SFR did not differ between the groups for ureteral stones <5 mm, but was higher in prestented than in nonstented patients for ureteral calculi ≥ 5 mm (98.2% vs 83.3%, P ≤ .0105). For urinary calculi ≥ 5 mm, the overall SFR was higher in prestented than in nonstented patients (93.3 vs 78.3%, P ≤ .0054). Perioperative complications occurred in 27 patients (9.4%; Clavien I, 6.6%; Clavien IIIb, 2.8%) without differences between the groups.


CONCLUSIONS
URS is a safe and efficacious procedure for the treatment of nephroureterolithiasis. Preoperative ureteral stent placement is associated with higher SFRs compared with nonstented patients for urinary calculi ≥ 5 mm. Nonstented patients with urinary calculi ≥ 5 mm should be informed about the risk for a second-look URS procedure.
Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany. c.netsch@asklepios.com
Christopher
C
Netsch
Sophie
S
Knipper
Thorsten
T
Bach
Thomas R W
TR
Herrmann
Andreas J
AJ
Gross
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D015607:Stents; D014514:Ureteral Calculi / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D018666:Ureteroscopy; D055815:Young Adult