Cases of ureteroscopic lithotripsy without postoperative ureteral stent placement
The purpose of ureteral stent placement after transurethral ureterolithotripsy (TUL) is to help stones pass and prevent hydronephrosis and infection. However, stent-related symptoms lower patient’s QOL and, also encourage use of painkillers. From January 2018 to June 2019, we underwent TUL withou...
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| Published in | Japanese Journal of Endourology Vol. 34; no. 1; pp. 104 - 107 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of Endourology
2021
日本泌尿器内視鏡学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2186-1889 2187-4700 |
| DOI | 10.11302/jsejje.34.104 |
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| Abstract | The purpose of ureteral stent placement after transurethral ureterolithotripsy (TUL) is to help stones pass and prevent hydronephrosis and infection. However, stent-related symptoms lower patient’s QOL and, also encourage use of painkillers. From January 2018 to June 2019, we underwent TUL without postoperative ureteral stent placement (hereinafter called Stentless TUL) on 21 patients and examined the results. The median age was 63 years old, the stone location was R2 : 2, U1 : 6, U2 : 3, U3 : 10, and the median stone major axis was 8 mm. The median operation time was 27 minutes, and endoscopic stone free was confirmed in all cases. There were no serious postoperative complications. From these results, it was considered we can perform Stentless TUL safely in some cases, and should expand the indications in the future. |
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| AbstractList | The purpose of ureteral stent placement after transurethral ureterolithotripsy (TUL) is to help stones pass and prevent hydronephrosis and infection. However, stent-related symptoms lower patient’s QOL and, also encourage use of painkillers. From January 2018 to June 2019, we underwent TUL without postoperative ureteral stent placement (hereinafter called Stentless TUL) on 21 patients and examined the results. The median age was 63 years old, the stone location was R2 : 2, U1 : 6, U2 : 3, U3 : 10, and the median stone major axis was 8 mm. The median operation time was 27 minutes, and endoscopic stone free was confirmed in all cases. There were no serious postoperative complications. From these results, it was considered we can perform Stentless TUL safely in some cases, and should expand the indications in the future. The purpose of ureteral stent placement after transurethral ureterolithotripsy (TUL) is to help stones pass and prevent hydronephrosis and infection. However, stent-related symptoms lower patient’s QOL and, also encourage use of painkillers. From January 2018 to June 2019, we underwent TUL without postoperative ureteral stent placement (hereinafter called Stentless TUL) on 21 patients and examined the results. The median age was 63 years old, the stone location was R2 : 2, U1 : 6, U2 : 3, U3 : 10, and the median stone major axis was 8 mm. The median operation time was 27 minutes, and endoscopic stone free was confirmed in all cases. There were no serious postoperative complications. From these results, it was considered we can perform Stentless TUL safely in some cases, and should expand the indications in the future. 経尿道的尿路結石砕石術 (TUL) 直後の尿管ステント留置の目的は自排石率の向上や, 水腎症および感染の予防とされるが, 一方でステント関連症状によりQOLを低下させ, 術後の鎮痛剤の使用量が増えるなどの欠点もある. 当院で2018年1月から2019年6月までに, 術後に尿管ステントを留置しないTUL (以後Stentless TULと呼ぶ) を行った21例を対象とし, その結果を検討した. 年齢中央値は67歳, 結石部位は R2 : 2例, U1 : 6例, U2 : 3例, U3 : 10例で, 結石長径中央値は8 mmだった. 手術時間中央値は27分, 全例でendoscopic stone freeを確認した. 重篤な合併症を来した症例はなかった. これらの結果から, Stentless TULは条件により可能であり, さらに適応を拡大すべきと考えられた. |
| Author | 田 寛之 山田 裕二 松本 穣 村蒔 基次 今井 聡士 |
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| References | 4) Ahmet YM, Sven F, Antonio F, et al. (2017) Risks and benefits of postoperative double-J stent placement after ureteroscopy : Results from the Clinical Research Office of Endourological Society Ureteroscopy Global Study. J Endourol 32 : 477-481 7) Mosli HA, Farsi HM, Al-Zimaity MF, et al. (1991) Vesicoureteral reflux in patients with double pigtail stents. J Urol 146 : 966-969 8) Hosking DH, McColm SE, Smith WE (1999) Is stenting following ureteroscopy for removal of distal ureteral calculi necessary? J Urol 161 : 48-50 10) 加藤祐司, 小関達郎, 松谷 亮, 他 (2018) 尿管ステントの留置期間短縮によるTUL後の有熱性尿路感染症の抑制効果について. Jpn J Endourol 31 : 212-217 2) Itay MS, Aiman I, Ioannis K, et al. (2018) Does retrograde treatment of upper urinary tract stones necessitate postoperative upper urinary tract drainage? Conclusions from more than 500 single center consecutive cases. J Endourol 31 : 446-451 11) 米田 慧, 矢野 仁, 岡 了, 他 (2018) 後期高齢者の上部尿路結石に対する経尿道的破砕術 (URS) の検討. Jpn J Endourol 31 : 126-129 1) Joshi HB, Okeke A, Newns N, et al. (2002) Characterization of urinary symptoms in patients with ureteral stents. Urology 59 : 511-519 5) Traxer O, Thomas A (2013) Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol 189 : 580-584 9) Shields JM, Bird VG, Graves R, et al. (2009) Impact of preoperative stenting on outcome of ureteroscopic treatment for urinay lithiasis. J Urol 182 : 2768-2774 12) Joshi HB, Newns N, Stainthorpe A, et al. (2003) Ureteral stent symptom questionnaire : development and validation of a multidimensional quality of life measure. J Urol 169 : 1060-1064 3) Kehinde EO, Rotimi VO, Al-Hunayan A, et al. (2002) Factors predisposing to urinary tract infection after J ureteral stent insertion. J Urol 167 : 1334-1337 6) Sugihara T, Yasunaga H, Horiguchi H, et al. (2013) A nomogram predicting severe adverse events after ureteroscopic lithotripsy : 12372 patients in a Japanese national series. BJU Int 111 : 459-466 |
| References_xml | – reference: 3) Kehinde EO, Rotimi VO, Al-Hunayan A, et al. (2002) Factors predisposing to urinary tract infection after J ureteral stent insertion. J Urol 167 : 1334-1337 – reference: 4) Ahmet YM, Sven F, Antonio F, et al. (2017) Risks and benefits of postoperative double-J stent placement after ureteroscopy : Results from the Clinical Research Office of Endourological Society Ureteroscopy Global Study. J Endourol 32 : 477-481 – reference: 5) Traxer O, Thomas A (2013) Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol 189 : 580-584 – reference: 6) Sugihara T, Yasunaga H, Horiguchi H, et al. (2013) A nomogram predicting severe adverse events after ureteroscopic lithotripsy : 12372 patients in a Japanese national series. BJU Int 111 : 459-466 – reference: 7) Mosli HA, Farsi HM, Al-Zimaity MF, et al. (1991) Vesicoureteral reflux in patients with double pigtail stents. J Urol 146 : 966-969 – reference: 1) Joshi HB, Okeke A, Newns N, et al. (2002) Characterization of urinary symptoms in patients with ureteral stents. Urology 59 : 511-519 – reference: 11) 米田 慧, 矢野 仁, 岡 了, 他 (2018) 後期高齢者の上部尿路結石に対する経尿道的破砕術 (URS) の検討. Jpn J Endourol 31 : 126-129 – reference: 8) Hosking DH, McColm SE, Smith WE (1999) Is stenting following ureteroscopy for removal of distal ureteral calculi necessary? J Urol 161 : 48-50 – reference: 10) 加藤祐司, 小関達郎, 松谷 亮, 他 (2018) 尿管ステントの留置期間短縮によるTUL後の有熱性尿路感染症の抑制効果について. Jpn J Endourol 31 : 212-217 – reference: 9) Shields JM, Bird VG, Graves R, et al. (2009) Impact of preoperative stenting on outcome of ureteroscopic treatment for urinay lithiasis. J Urol 182 : 2768-2774 – reference: 2) Itay MS, Aiman I, Ioannis K, et al. (2018) Does retrograde treatment of upper urinary tract stones necessitate postoperative upper urinary tract drainage? Conclusions from more than 500 single center consecutive cases. J Endourol 31 : 446-451 – reference: 12) Joshi HB, Newns N, Stainthorpe A, et al. (2003) Ureteral stent symptom questionnaire : development and validation of a multidimensional quality of life measure. J Urol 169 : 1060-1064 |
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| Title | Cases of ureteroscopic lithotripsy without postoperative ureteral stent placement |
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