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Short-term external ureteric catheterisation vs routine double-j stenting after ureteroscopic stone extraction: a comparative study

Author: 
Dr. Surya Kant Kumar, Dr. Prakash, J.V.S. and Dr. Balaji, AR.
Subject Area: 
Health Sciences
Abstract: 

Background: We compared outcome and complications after ureteroscopic treatment of ureteric calculi with short term external ureteric catheterisation vs routine use of double-j ureteral stenting. Methods: Between August 2017 and August 2018, 80 patients were prospectively randomized to double‐J stent insertion for 7 days vs ureteric catheterisation for 24 hours after ureteroscopic stone extraction. Exclusion criteria were active UTI, solitary kidney, stone size more than 20 mm or deranged renal function test. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS), analgesia need, rehospitalisation, stone-free rate, and late postoperative complications were all studied. Results: There was no significant difference between the two groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in group who received short term UC. When comparing two groups, patients with double j stents had statistically significantly more bladder pain (P-0.003), frequency/urgency (P-0.002), dysuria (P-0.001). and need of analgesics (P-0.001). Conclusion: Ureteroscopy for ureteral calculi can safely be performed without placement of a double-j ureteral stent. A short‐term ureteric catheter insertion for 24 hours following ureteroscopic retrograde stone removal is a safe procedure and superior to double‐J stent insertion with regard to urinary symptoms, pain, quality of life, and stent related symptoms. Patients treated with a short‐term ureteric catheter recover more quickly, return to work earlier, and need less doctor visit and may prefer this strategy in case of future stone treatment.

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