The Impact of One Week of Pre-Stenting on Porcine Ureteral Luminal Circumference

Jiang, Pengbo; Afyouni, Andrew Shea; Brevik, Andrew; Peta, Akhil; King, Tori; Dinh, Samantha T; Ayad, Maged; Larson, Krista; Limfueco, Luke; Kosmala, Christina; Mirzaei, Hossein; Landman, Jaime; Clayman, Ralph V.

doi:10.1089/end.2021.0771

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…Mogilevkin and others indicated that an indwelling double-J stent, a history of previous ureteroscopy or double-J stent, and older age were significant predictors for an effective 14F UAS insertion In our study, we found sex but not age was a possible predictor for UAS placement, which was similar to a previous study, and anatomical features of the urethra and ureter may be associated with this outcome [11]. Many studies have suggested that indwelling double-J stents result in higher success rates for UAS placement as ureteral stenting increases the luminal circumference of ureters [1,4,5,14]. Patients who received preoperative ureteral stenting were not included in this study because EAU guidelines did not suggest routine placement of ureteral stents before RIRS [4,6].…”

Section: Discussionsupporting

confidence: 87%

“…Stent placement before RIRS can theoretically expand the ureter to improve access, and data showed prestenting resulted in higher success for UAS placement and also minimized intraoperative ureteric injury [1,4]. In vitro experiments showed that one week of ureteral stenting resulted in nearly a 4Fr increase in the luminal circumference of porcine ureters [5]. Nevertheless, European Association of Urology (EAU) guidelines did not suggest the routine placement of ureteral stents before RIRS [4,6]; it is of significant importance to identify risk factors for the failure of ureteral access sheath placement.…”

Section: Introductionmentioning

confidence: 99%

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Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

Liu

et al. 2022

International Journal of Clinical Practice

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Purpose. Insertion of a ureteral access sheath (UAS) may fail in some patients in retrograde intrarenal surgery (RIRS), and this study aimed to seek preoperative risk factors for the failure of 12/14F UAS placement. Methods. We retrospectively analyzed 260 consecutive patients who underwent RIRS between May 2020 and March 2022 at our institution. Data on patient and stone characteristics and several computed tomography (CT)-based measurements were collected and compared between the success and failure UAS placement groups. Results. Twenty-nine (11.2%) patients failed to insert the UAS. Age, gender, height, weight, stone side, stone location, length of history, and computed tomography (CT)-based parameters were not significant differences between the two groups. Univariate logistic regression analyses showed sex (female/male) (odds ratio: 0.287 and 95% CI [0.107, 0.722], p = 0.013 ), length of history 15–31 days (odds ratio: 0.315 and 95% CI [0.102, 0.974], p = 0.045 ), length of history >31 days (odds ratio: 0.202 and 95% CI [0.051, 0.805], p = 0.023 ), and diameter of the ipsilateral common iliac artery (odds ratio: 1.285 and 95% CI [1.018, 1.623], p = 0.035 ) were associated with UAS placement. Conclusion. Our study indicated that males, the short length of history, and the short diameter of the ipsilateral common iliac artery were the risk factors for the failure of UAS placement.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

Liu

et al. 2022

International Journal of Clinical Practice

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“…They both found that pre-stenting resulted in a higher success for UAS placement, lower intraoperative ureteric injuries and higher overall SFRs (defined as no residual fragment at all) [ 54 , 55 ]. In a recent study on porcine ureters, one week of prestenting resulted in a 3.8 Fr increase in the luminal diameter [ 56 ], as measured by xyz-methodology. Of interest, stent size (4.7 Fr vs. 7 Fr) and laterality (left vs. right) did not impact the degree of ureteral enlargement.…”

Section: Resultsmentioning

confidence: 99%

Ureteral Access Sheaths and Its Use in the Future: A Comprehensive Update Based on a Literature Review

Coninck

Somani

Şener

et al. 2022

JCM

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Ureteral access sheaths (UASs) are part of urologist’s armamentarium when performing retrograde intrarenal surgery (RIRS). Recently, the world of RIRS has changed dramatically with the development of three game-changers: thulium fiber laser (TFL), smaller size single use digital flexible ureterosopes and intraoperative intrarenal pressure (IRP) measurement devices. We aimed to clarify the impact of UASs on IRP, complications and SFRs and put its indications in perspective of these three major technological improvements. A systematic review of the literature using the Medline, Scopus and Web of Science databases was performed by two authors and relevant studies were selected according to PRISMA guidelines. Recent studies showed that using a UAS lowers IRP and intrarenal temperature by increasing irrigation outflow during RIRS. Data on the impact of a UAS on SFRs, postoperative pain, risk of infectious complications, risk of ureteral strictures and risk of bladder recurrence of urothelial carcinoma after diagnostic RIRS were inconclusive. Prestenting for at least one week resulted in ureteral enlargement, while the influence of pre-operative administration of alpha-blockers was unclear. Since TFL, smaller single use digital ureteroscopes and devices with integrated pressure-measuring and aspiration technology seemed to increase SFRs and decrease pressure and temperature related complications, indications on the use of a UAS may decrease in the near future.

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“…P. Jiang и соавт. отметили увеличение диаметра мочеточника через 7 дней на фоне мочеточникового стента на моделях свиней в среднем на 4Ch [20]. По нашему мнению, избыточное натяжение в зоне анастомоза может быть нивелировано путем предстентирования, так как это способствует пассивной дилятации мочеточника.…”

Section: Discussionunclassified

Estimation of the results of laparoscopic pyeloplasty in primary strictures of the pelvic-ureteral segment.

Panferov,

Bekreev,

Malkhasyan

2023

ECU

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Introduction. In 1993, W.W. Schuessler et al. laparoscopic pyeloplasty was reported, and since that time the number of interventions performed with such access has increased significantly. Laparoscopic pyeloplasty does not exclude possible complications, including early ones - urinary congestion, anastomosis failure and distant ones, restenosis and obliteration of the ureteral lumen, which can develop as a result of ischemia due to excessive tissue tension. There are isolated references in the literature about the positive effect of prestenting on the results of pyeloplasty. Objective. Estimate the results of laparoscopic pyeloplasty in patients without prestenting and with prestenting. Materials and methods. A retrospective analysis of the treatment of 73 patients with stricture of the pelvic ureteral segment is presented. All patients were divided into two groups: I (main) – 17 patients whose upper urinary tract was drained by a ureteral stent at the time of surgery, II (control) - 56 patients who had not previously had upper urinary tract drainage. Results. The results, nature and frequency of complications of laparoscopic pyeloplasty in patients with and without prestenting are analyzed. The average operation time in group I was about 153.85 minutes, in group II - 116.7 minutes, the average drainage time in group I was 22.1 hours, in group II - 30.8 hours. Requirement for analgesics: group I – 48.5 mg/day, group II – 56.2 mg/day. In group I, one complication (5.9%) of category 1 was recorded - an attack of pyelonephritis and one case of complications (5.9%) of category 3a (urinoma). In group II, 6 cases (10.7%) of category 1 complications, 9 cases (16.1%) of category 3a complications were recorded. The results according to MSCT, performed 3 months after surgery, demonstrated restoration of patency at the level of the ureteropelvic segment. Conclusions. Prestenting of the ureter reduces the frequency of postoperative complications during laparoscopic pyeloplasty and eliminates the need for additional mobilization of the kidney for the formation of ureteropyeloanastomosis without excessive tension.

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The Impact of One Week of Pre-Stenting on Porcine Ureteral Luminal Circumference

Cited by 6 publications

References 29 publications

Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

Ureteral Access Sheaths and Its Use in the Future: A Comprehensive Update Based on a Literature Review

Estimation of the results of laparoscopic pyeloplasty in primary strictures of the pelvic-ureteral segment.

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