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Article Dans Une Revue Progrès en Urologie Année : 2019

Double J stenting evaluation after ureteroscopy for urolithiasis

Résumé

Objectives: During ureteroscopy for urolithiasis, postoperative ureteral drainage with double J stent is frequently used. It may reduce acute postoperative pain and late ureteral stenosis. Double J stent can have negative impact on life quality. After uncomplicated intervention, double J stent is not mandatory. Objective of our study was to evaluate pain and complications after ureteroscopy with or without stent. Methods: We retrospectively analyzed ureteroscopy performed between May 2014 and January 2017. Interventions were compared regarding ureteral drainage with double J stent or not. Our primary outcome was early postoperative pain evaluated with an oral pain scale form 1 to 10 on day one after intervention. Clinical characteristics, per- and postoperative data were collected. We also looked for risks factors of complications. Results: Three hundred and sixty-six interventions were included, 259 (70.8%) with and 107 (29.2%) without double J stent. Stone burden was higher in stented group (18.3 vs 9.4mm, P<0.0001). Patients without postoperative stents had more ureteral preparation with double J stent (78.5% vs 62.5%, P=0.0032) and had more ambulatory interventions (75.7% vs 52.5%, P<0.0001). Postoperative pain was not different (22% vs 17.75%, P=0.398). Complication rate was similar (29% vs 20.5%, P=0.1181), so was rehospitalization rate (0.8% vs 0.9%, P=1). In multivariate analysis, complications factors were unprepared ureter, experienced surgeons and access sheath. Conclusion: Not stenting after ureteroscopy do not increase pain or complications. Stenting should not be used after uncomplicated interventions for centimetric stones.
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hal-02416137 , version 1 (20-07-2022)

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Paternité - Pas d'utilisation commerciale

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T. Segalen, S. Lebdai, P. Panayotopoulos, T. Culty, E. Brassart, et al.. Double J stenting evaluation after ureteroscopy for urolithiasis. Progrès en Urologie, 2019, 29 (12), pp.589-595. ⟨10.1016/j.purol.2019.08.266⟩. ⟨hal-02416137⟩
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