LOWER URETERIC STONES

TO FIND OUT THE TREATMENT RESULTS & COMPLICATIONS OF REMOVAL OF LOWER URETERIC STONES WITH OR WITHOUT STENTING THE URETER.

Abstract

Aims & Objectives: Placement of a ureteral stent is routinely done followed by
ureteroscopy. Recently, many researchers have questioned routine stenting after ureteroscopy
for management of distal ureteric stones? We report our outcomes of a randomized study
comparing ureteroscopy with and without placement of stents for management of distal
ureteric stones. Study Design: Randomized controlled trial. Setting: Department of Urology,
Jinnah Hospital/ Allama Iqbal Medical College, Lahore. Period: March 2013 to February, 2015.
Materials & methods: Total 155 patients were prospectively divided into three groups to receive
a double J stent (Group I, 54 patients), ureteral stent (Group II, 50 patients) and no stent (Group
III, 51 patients), underwent ureteroscopic treatment of distal ureteric stones. Characteristics of
stones, operation time, postoperative pain, lower urinary tract symptoms, and analgesia need
for postoperative pain, hospitalization, stone free rate and late postoperative complications
were all studied. Results: There were no significant differences in preoperative data. There
was no statistical significant difference between three groups regarding hematuria, fever, flank
pain, urinary tract infection and re-hospitalization. At 48 hours and 1 week, frequency/ urgency
and dysuria were significantly less group III. When comparing Group I and Group III, patients
with double J stent has statistically significant more bladder pain 0, frequency/ urgency 0,
dyusuria 0 and need of analgesia 0. All patients of the three groups assessed postoperatively
by imaging did not suffer any obstruction or ureteral stricture. Conclusion: Uncomplicated
ureteroscopy without stent placement for treatment of distal ureteral stones is a safe procedure.
Patients without stents have significantly fewer irritative bladder symptoms and are not at risk
of complications.