Short‐term external ureter stenting shows significant benefit in comparison to routine double‐J stent placement after ureterorenoscopic stone extraction: A prospective randomized trial – the Fast track stent study (Fa<scp>ST</scp>)

Reicherz, Alina; Teichman, Joel M.H.; Dahlkamp, Lisa; Landenberg, Nicolas von; Palisaar, Rein-Jueri; Noldus, Joachim; Bodman, Christian von

doi:10.1111/iju.13711

Cited by 25 publications

(24 citation statements)

References 20 publications

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“…When indicated, a second intervention was carried out, and a DJ stent inserted. In the FaST 1 protocol, the reintervention rate in the UC group was 8.3%, whereas no reintervention was required in the DJ stent group 8 . One reason for the decreased reintervention rate in the UC group between FaST 1 and 2 might be the increased level of experience with the UC protocol.…”

Section: Discussionmentioning

confidence: 99%

“…FaST 2 is the subsequent phase of the prospective randomized FaST 1 trial, which compared postoperative short‐term UC versus DJ stenting, showing significantly better QoL in the short‐term UC arm in the same clinical setting with regard to urinary symptoms, pain, general health and work index ( P < 0.0001) 8 …”

Section: Discussionmentioning

confidence: 99%

“…In the first study (FaST 1), 124 pre‐stented patients who underwent DJ stent insertion after URS were compared with patients who were treated with a postoperative external UC for 6 h. We were able to show that patients receiving a UC benefit from a significantly improved QoL, compared with those undergoing routine DJ stent insertion, by means of validated tool (USSQ), at the cost of an increased reintervention rate 8 …”

Section: Introductionmentioning

confidence: 99%

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Transient stent placement versus tubeless procedure after ureteroscopy retrograde surgery stone extraction (Fast Track Stent study 2): A randomized prospective evaluation

et al. 2020

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Objectives To determine whether in pre‐stented patients undergoing ureteroscopic stone removal (ureteroscopy retrograde surgery) a tubeless procedure provides a better outcome compared with short‐term (6 h) ureteral stenting using an external ureteral catheter. Methods In this single academic center study (Fast Track Stent study 2), carried out between May 2016 and April 2018, 121 patients with renal or ureteral calculi were initially treated with double‐J insertion. Before secondary ureteroscopy retrograde surgery, patients were prospectively randomized into two groups: tubeless versus ureteral catheter insertion for 6 h after ureteroscopy retrograde surgery. Exclusion criteria were acute urinary tract infection, solitary kidney or stone diameter >25 mm. Study end‐points were stent‐related symptoms assessed by a validated questionnaire (ureteral stent symptom questionnaire), administered both before and 4 weeks after surgery. Numerical ureteral stent symptom questionnaire scores were compared using the Mann–Whitney‐U‐test. The level of significance was defined as P < 0.05. Results Ureteroscopy retrograde surgery procedures carried out by 13 surgeons resulted in >90% stone removal in all patients (n = 121), with a mean operation time of 19.9 versus 18.0 min for ureteral catheter versus tubeless, respectively (P = 0.37). Patient groups did not differ significantly in their ureteral stent symptom questionnaire scores (urinary index P = 0.24; pain index P = 0.35). Patients showed a significant preference for tubeless procedure over ureteral catheter reinsertion (Question GQ P < 0.0001). The reintervention rate was 13.3% for the tubeless procedure (n = 8) and 1.6% for the ureteral catheter group (n = 1), respectively (P = 0.034). Conclusions Short‐term ureteral catheter and no stent insertion after ureteroscopy retrograde surgery stone extraction in pre‐stented patients result in comparable quality of life. However, the reintervention rate is higher for tubeless procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transient stent placement versus tubeless procedure after ureteroscopy retrograde surgery stone extraction (Fast Track Stent study 2): A randomized prospective evaluation

et al. 2020

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“…3). The results of the prospective randomized study (FaST 1) showed that inserting a mono J compared to a DJ catheter after a secondary URS has resulted in a significant increase in quality of life [13]. The question comes up whether German urological departments can afford guideline and evidence-based urolithiasis therapy with constant pressure for cost efficiency.…”

Section: Discussionmentioning

confidence: 99%

An Empirical Study on the Operative Treatment of Symptomatic Urolithiasis in Germany

et al. 2021

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Purpose: The guidelines of the German, European, and American Urological Associations on urolithiasis advise against general ureteral stenting before and after an uncomplicated ureterorenoscopy (URS). However, German and European guidelines state that stenting prior to URS facilitates stone extraction and reduces intraoperative complications. According to the published literature, German practice seems to deviate from recommendations. This nationwide survey aimed to evaluate the treatment modalities of urolithiasis. Methods: In November 2018 and March 2019, a total of 199 urological hospital departments in Germany were anonymously surveyed about operative care of symptomatic urolithiasis. The response rate was 72.9%. The survey consisted of 25 questions about diagnostics, surgical technique, and aftercare of the URS. This questionnaire is available in the appendix. Results: A primary URS is performed in ≤10% in 49.6% of the hospitals. In every second urological department (49.7%), the German Diagnosis Related Group (G-DRG) system influences the period of pre-stenting before a secondary URS. After a secondary URS, which is performed in 53.8% of the departments in over 80% of the patients, 14% of the departments omit stenting. The standard for stenting seems to be a 28-cm-long 7 Charrière double-J stent in Germany. Conclusion: In Germany, the percentage of primary URS is low, and a ureter stenting is performed in most of the urological departments after URS. Delaying therapy due to economic aspects is the standard in almost half of all urological departments.

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“…14 Bach et al reported that patients preferred having a ureteric catheter for 6 h following ureteroscopy (URS) compared with a stent, again confirming earlier similar studies. 15 Tharwat et al reported that sildenafil helps relieve stent symptoms, 16 but Tae et al found that mirabegron does not help. 17 The take-home message from these studies is clear: use a stent only when necessary and for as short a time as possible.…”

Section: Endourology (Fxk)mentioning

confidence: 99%

Urology highlights 2017 to 2018

Biers

Walton

Belal

et al. 2019

Journal of Clinical Urology

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The final clinical session of the British Association of Urological Surgeons (BAUS) annual meeting is the Updates and Highlights session, where the most important advances in the main urological sub-specialities are summarised and presented by sub-specialist experts representing each BAUS section. The aim of the session is to disseminate knowledge on the latest research, new guidelines and changes to general and specialist clinical practice. This paper covers contemporary urological advances as presented at the Liverpool BAUS meeting in June 2018.

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Short‐term external ureter stenting shows significant benefit in comparison to routine double‐J stent placement after ureterorenoscopic stone extraction: A prospective randomized trial – the Fast track stent study (FaST)

Cited by 25 publications

References 20 publications

Transient stent placement versus tubeless procedure after ureteroscopy retrograde surgery stone extraction (Fast Track Stent study 2): A randomized prospective evaluation

Transient stent placement versus tubeless procedure after ureteroscopy retrograde surgery stone extraction (Fast Track Stent study 2): A randomized prospective evaluation

An Empirical Study on the Operative Treatment of Symptomatic Urolithiasis in Germany

Urology highlights 2017 to 2018

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