Outcomes and complications from a randomized controlled study comparing conventional stent placement versus no stent placement after ureteroscopy for distal ureteric calculus < 1 cm
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info:eu-repo/semantics/openAccessAttribution 4.0 Internationalhttps://creativecommons.org/licenses/by/4.0/Date
2022Author
Reddy, Suraj JayadevaReddy, Bathi Sourabh
Chawla, Arun
de la Rosette, Jean J. M. C. H.
del Pilar Laguna Pes, Maria
Hegde, Padmaraj
Shah, Abhijit
Choudhary, Anupam
Kankaria, Sanket
Hiremath, Vivekanand Kedarlingayya
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Reddy, S. J., Reddy, B. S., Chawla, A., de la Rosette, J. J. M. C. H., del Pilar Laguna Pes, M. ve Hegde, P. (2022). Outcomes and complications from a randomized controlled study comparing conventional stent placement versus no stent placement after ureteroscopy for distal ureteric calculus < 1 cm. Journal of Clinical Medicine, 11(23). https://doi.org/10.3390/jcm11237023Abstract
Ureteric stent insertion following ureteroscopic lithotripsy (URSL) is a common and widely accepted procedure. However, there is no agreement on whether a ureteric stent should be placed following an uncomplicated URSL. Furthermore, the definition of uncomplicated URSL remains debatable. To compare the efficacy, safety, and morbidity of no stent placement with the conventional stent placement after uncomplicated retrograde semirigid URS for a distal ureteric calculus of size <= 1 cm, we compared the corresponding complication rates, emergency visits, secondary interventions, and pain at follow-up. Following an uncomplicated ureteroscopic lithotripsy, 104 patients were randomized into the conventional stented group (CSG) and nonstented group (NSG). Lower urinary tract symptoms and sexual function were evaluated using validated questionnaires (IPSS + IIEF-5 + MSHQ-EjD/FSFI) preoperatively and at 4 weeks during follow-up. Pain scores at follow-up were recorded using a visual analogue scale (VAS). Patients who visited the emergency room or needed secondary interventions before the recommended follow-up time were noted. The Generalized Estimating Equations method was used to explore the difference in change in the domains of IPSS, IIEF-5, MSHQ-EjD, and FSFI between the two groups over time. A significant difference was noted in the following IPSS domains: Frequency, Urgency, Nocturia, Storage Symptoms, Total IPSS Score (p <= 0.001), and QoL (p = 0.002); IIEF-5 domains: Overall Score (p = 0.004); MSHQ-EjD domains: Ejaculation Bother/Satisfaction (p <= 0.001); and FSFI domains: Lubrication (p <= 0.001), Satisfaction (p = 0.006), and Overall Score (p = 0.004). There was no significant difference between the various groups in terms of distribution of emergency visits, readmission and secondary interventions, pain at follow-up (VAS), and need for long-term analgesia. Nonplacement of stents after uncomplicated URS decreases stent-related symptoms and preserves QoL without placing the patient under increased postoperative risk.