Unplanned Emergency Department Visits and Hospital Admissions Following Ureteroscopy: Do Ureteral Stents Make a Difference?

• Published in: Urology (Ridgewood, N.J.) Vol. 117; pp. 44 - 49
• Main Authors: Mittakanti, Harsha R., Conti, Simon L., Pao, Alan C., Chertow, Glenn M., Liao, Joseph C., Leppert, John T., Elliott, Christopher S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2018
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Emergency Service, Hospital - statistics & numerical data; Female; Humans; Lithotripsy, Laser; Male; Middle Aged; Patient Admission - statistics & numerical data; Postoperative Complications - etiology; Stents - statistics & numerical data; Ureteroscopy - adverse effects; Ureteroscopy - methods; Urinary Calculi - surgery; Young Adult
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2018.03.019

To evaluate unplanned medical visits within the early postoperative period after ureteroscopy in patients with and without ureteral stent placement. We identified all ureteroscopic procedures for urinary stone disease in the California Office of Statewide Health Planning and Development database from 2010 to 2012. The primary outcome was any emergency department visit or inpatient hospital admission in the first 7 days following ureteroscopy. Patients were subcategorized by type of ureteroscopy (ie, laser lithotripsy vs basket retrieval) and were analyzed for significant differences between stented and unstented patients. Multivariable logistic regression was performed to determine if ureteral stent placement was independently associated with unplanned visits. Our analytic cohort included 16,060 patients undergoing 17,716 ureteroscopy procedures. A ureteral stent was placed in 86.2% of patients undergoing laser lithotripsy and in 70.5% of patients receiving basket retrieval. In the 7 days following ureteroscopy, 6.6% of patients were seen in the emergency department and 2.2% of patients were admitted to a hospital. In a fully adjusted model, the utilization of a ureteral stent was not associated with emergency department visits or inpatient admissions. Ureteral stent placement during ureteroscopy is not associated with an increased odds of emergency department visits and inpatient admissions in the early postoperative period.