Contemporary Practice Patterns of Flexible Ureteroscopy for Treating Renal Stones: Results of a Worldwide Survey

Dauw, Casey A.; Simeon, Laika; Alruwaily, Abdulrahman F.; Sanguedolce, Francesco; Hollingsworth, John M.; Roberts, William W.; Faerber, Gary J.; Wolf, J. Stuart; Ghani, Khurshid R.

doi:10.1089/end.2015.0260

Cited by 119 publications

(86 citation statements)

References 23 publications

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“…However, because of the lack of an established standard, the choice of stents for the treatment of ureteral stones is often a matter of surgical preference and experience. A survey carried out last year showed that 63% of the surgeons still routinely stented patients following URL [38]. Although ureteral stents are used differently in ESWL and URL, the function and purpose are similar.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones

Wang

Man

et al. 2017

PLoS ONE

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Background and aimUreteroscopic lithotripsy (URL) and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteral stones. The need for ureteral stenting during these procedures is controversial. In this meta-analysis, we evaluated the benefits and disadvantages of ureteral stents for the treatment of ureteral stones.MethodsDatabases including PubMed, Embase and Cochrane library were selected for systematic review of randomized controlled trials (RCTs) comparing outcomes with or without stenting during URL and ESWL. Meta-analysis was performed using RevMan 5.3 and STATA 13.0 software.ResultsWe identified 22 RCTs comparing stenting and non-stenting. The stented group was associated with longer operation time (WMD: 4.93; 95% CI: 2.07 to 7.84; p < 0.001), lower stone-free rate (OR: 0.55; 95% CI: 0.34 to 0.89; p = 0.01). In terms of complications, the incidence of hematuria (OR: 3.68; 95% CI: 1.86 to 7.29; p < 0.001), irritative urinary symptoms (OR: 4.40; 95% CI: 2.19 to 9.10; p < 0.001), urinary infection (OR: 2.23; 95% CI: 1.57 to 3.19; p < 0.001), and dysuria (OR: 3.90; 95% CI: 2.51 to 6.07; p < 0.001) were significantly higher in the stented group. No significant differences in visual analogue score (VAS), stricture formation, fever, or hospital stay were found between stenting and non-stenting groups. The risk of unplanned readmissions (OR: 0.63; 95% CI: 0.41 to 0.97; p = 0.04) was higher in the non-stented group.ConclusionsOur analysis showed that stenting failed to improve the stone-free rate, and instead, it resulted in additional complications. However, ureteral stents are valuable in preventing unplanned re-hospitalization. Additional randomized controlled trials are still required to corroborate our findings.

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Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones

Wang

Man

et al. 2017

PLoS ONE

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“…These findings are important in the context of the increasing use of flexible ureteroscopy, especially for larger renal stones. 23,24 In fact, investigators have suggested that ureteroscopy may indeed be the treatment of choice for obese patients with renal stones based on perceived …”

Section: Discussionmentioning

confidence: 99%

Percutaneous Nephrolithotomy in the Superobese: A Comparison of Outcomes Based on Body Mass Index

Dauw

Borofsky

York

et al. 2016

Journal of Endourology

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Introduction: Percutaneous nephrolithotomy (PCNL) is considered the gold standard for treatment of large renal calculi. Although several investigators have examined the feasibility and outcomes associated with PCNL in obese patients, these studies have been limited by small sample size, lack of a comparator group, or few patients at body mass index (BMI) extremes. We thus compared outcomes of superobese (BMI >50) patients undergoing PCNL vs both an ''overweight'' and ''ideal'' cohort. Methods: We used a prospectively maintained database to identify ideal (BMI 18.5-25), overweight (BMI 25.1-49.9), and superobese (BMI ‡50) patients who underwent PCNL. Our primary objective was to compare surgical outcomes between groups measured by the percent of patients who required secondary PCNL. We then compared complication rates, need for transfusion, and length of stay (LOS) using chi-square testing and ANOVA where appropriate. Results: A total of 1152 patients were identified of which 254 were classified as ideal, 840 as overweight, and 58 as superobese. The overweight cohort had a higher mean age and greater proportion of males, whereas staghorn stones were more common in the superobese group. Comorbid conditions were more commonly observed in the superobese cohort. Otherwise, the groups were similar. Surgical outcomes were comparable with 47.2%, 42.0%, and 38.0% of ideal, overweight, and superobese patients requiring secondary PCNL ( p = 0.25) with no difference in complication rates, need for transfusion, or LOS. Conclusion: PCNL can be effectively and safely performed in superobese patients with no difference in surgical outcomes or complications when compared to ideal or overweight patient cohorts.

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“…Improvement of the instruments as well as endoscopic technology has made flexible ureteroscopy (fURS) as an increasingly popular treatment option for patients with renal stones (Ghani & Wolf, 2015; Dauw et al, 2015; Wang & Preminger, 2011). Indication for fURS also has been extended, even for stone larger than 2 cm (Aboumarzouk et al, 2012; Breda et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis

Zhang

et al. 2016

PeerJ

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PurposeTo clarify the outcome of flexible ureteroscopy (fURS) for management of renal calculi without preoperative stenting.MethodsA total of 171 patients who received 176 fURS procedures for unilateral renal stones were reviewed. All procedures were divided into two groups depending on whether they received ureteral stenting preoperatively. Baseline characteristics of patients, stone burden, operation time, stone-free rates, and complications were compared between both groups.ResultsSuccessful primary access to the renal pelvis was achieved in 104 of 114 (91.2%) patients without preoperative stenting, while all procedures with preoperative stenting (n = 62) were successfully performed. A total of 156 procedures were included for further data analysis (56 procedures in stenting group and 100 in non-stenting group). No significant differences was found regardless of a preoperative stent placement in terms of stone-free rate (73.2% with stenting vs. 71.0% without, P = 0.854), operative time (70.4 ± 32.8 with stenting vs. 70.2 ± 32.1 without, P = 0.969).ConclusionsfURS for management of renal stone without preoperative ureteral stenting are associated with well outcome in short term follow-up. Our study may help patients and doctors to decide if an optional stent is placed or not.

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Contemporary Practice Patterns of Flexible Ureteroscopy for Treating Renal Stones: Results of a Worldwide Survey

Cited by 119 publications

References 23 publications

Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones

Meta-Analysis of Stenting versus Non-Stenting for the Treatment of Ureteral Stones

Percutaneous Nephrolithotomy in the Superobese: A Comparison of Outcomes Based on Body Mass Index

Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis

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