Prognostic implications of double J ureteral stenting in patients with renal stones undergoing extracorporeal shockwave lithotripsy
DOI:
https://doi.org/10.18203/2320-6012.ijrms20173639Keywords:
Double-J ureteral stenting, ESWL, Renal calculusAbstract
Background: Most patients with uncomplicated kidney stones can be successfully treated with extracorporeal shockwave lithotripsy (ESWL). Double-J ureteral stent is used to facilitate stone clearance, however double-J ureteral stents themselves may cause complications. Study conducted the study to know the exact role of double J stent in ESWL.
Methods: 80 patients undergoing ESWL were divided into two groups, group A (n=40) double J stenting and group B (n=40) without double J stenting. Both groups were compared for stone fragmentation, stone clearance, number of shockwaves required for fragmentation, time required for passing through ureter, steinstrasse, Urinary Tract Infection.
Results: Both the groups were comparable for age, sex, stone size and stone location distribution. There was no significant difference in clearance of stone and no. of shockwaves received for clearance in both the groups. The overall incidence of steinstrasse between the two groups was insignificant with a p value of 0.644. The incidence of UTI was significantly higher in stented group (p value 0.032).
Conclusions: Study recommend ESWL without double J stent in patients having solitary renal calculus of size < 2 cm. Double J stent predisposes the patient to multiple complications including urinary tract infection which increases the morbidity of the patient. Based on our study we conclude that double J stenting in patients of renal calculus of size < 2cm, prior to ESWL is not beneficial.
References
Andreassen KH, Dahl C, Andersen JT. Extracorporeal shock wave lithotripsy as first line monotherapy of solitary calyceal calculi. Scand J Urol Nephrol.1997;31:245-48.
Chaussy CG, Fuchs GJ. Current state and future developments of noninvasive treatment of human urinary stones with extracorporeal shock wave lithotripsy. J Urol.1989;141:782-9.
Chaussy C, Brendel W, Schmiedt E. Extracoporeally induced destruction of kidney stones by shock waves. Lancet. 1980;32:1265-8.
Kirkali Z, Esen AA, Akan G. Place of double J stents in extracorporeal shock wave lithotripsy. Eur Urol. 1993;23(4):460-2.
Carr LK, D’A Honey J, Jewett MA. New stone formation: a comparison of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. J Urol. 1996;155:1565-7.
Libby JM, Meacham RB, Griffith DP. The role of silicone ureteral stents in extracorporeal shock wave lithotripsy of large renal calculi. J Urol. 1988;139(1):15-7.
Pode D, Shapiro A, Verstandig A, Pfau A. Use of internal polyethylene ureteral stents in extracorporeal shock-wave lithotripsy of staghorn calculi. Eur Urol. 1987;13(3):174-5.
Preminger GM, Kettelhut MC, Elkins SL, Seger J, Fetner CD. Ureteral stenting during extracorporeal shock wave lithotripsy: help or hindrance? J Urol. 1989;142(1):32-6.
Pryor JL, Jenkins AD. Use of double-pigtail stents in extracorporeal shock wave lithotripsy. J Urol. 1990;143(3):475-8.
Chandhoke PS, Barqawi AZ, Wernecke C, Chee-Awai RA. A randomized outcomes trial of ureteral stents for extracorporeal shock wave lithotripsy of solitary kidney or proximal ureteral stones. J Urol. 2002;167(5):1981-3.
Cass AS. Ureteral stenting with extracorporeal shock-wave lithotripsy. Urol. 1992;39(5):446-8.
Gupta. Outcome of extracorporeal shock wave lithotripsy for renal calculus above 2 cm in size- a retrospective study. Innovat J Med Health Sci. 2013;3:131-5.
Mustafa. Stenting in extracorporeal shockwave lithotripsy; may enhance the passage of the fragments. J Pak Med Assoc. 2009;59(3):141-3.
Shen P, Jiang M, Yang J, Li X, Li Y, Wei W, et al. Use of ureteral stent in extracorporeal shock wave lithotripsy for upper urinary calculi: a systematic review and meta-analysis. J Urol. 2011;186(4):1328-35.
Sofimajidpour H, Rasti M, Gharibi F. The effect of a double-J stent in the treatment of kidney stones larger than 10 mm in children under 13 years, using extracorporeal shock wave lithotripsy (ESWL). Iran Red Crescent Med J. 2016;18(1):e24684.
Musa AAK. Use of double-J stents prior to extracorporeal shock wave lithotripsy is not beneficial: results of a prospective randomized study. Int Urol Nephrol. 2008;40:19.
Al-Awadi KA, Abdul Halim H, Kehinde EO, Al-Tawheed A. Steinstrasse: a comparison of incidence with and without J stenting and the effect of J stenting on subsequent management. BJU Int. 1999;84(6):618-21.
Bierkens AF, Hendrikx AJ, Lemmens WA, Debruyne FM. Extracorporeal shock wave lithotripsy for large renal calculi: the role of ureteral stents. A randomized trial. J Urol. 1991;145(4):699-702.
Obaid AT, Hussen RF. Role of double J stent in patients with renal stones undergo extracorporeal shock wave lithotripsy. Med J Babylon. 2012;9(3):629-42.
El-Assmy A, El-Nahas AR, Sheir KZ. Is pre-shock wave lithotripsy stenting necessary for ureteral stones with moderate or severe hydronephrosis? J Urol. 2006;176(5):2059-62.
