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Original Research

Long-term stone-free rates after flexible URS: Does the size of DJ stent affect the outcomes


1 Kafkas University, Medical School, Department of Urology, Kars, Turkey
2 Medistate Kavacık Hospital, Department of Urology, İstanbul, Turkey
3 Biruni University, Medical School, Department of Urology, İstanbul, Turkey


DOI : 10.33719/yud.2023;18-1-1188129
New J Urol. 2023;18(1):48-54

ABSTRACT

Objective

This study's main goal was to evaluate the possible impact of different-sized double-J (DJ) stents on the pain and stone-free status following flexible ureteroscopic laser disintegration (fURS) of renal stones.

Methods

A total of 104 patients who underwent fURS for kidney stones were included in our study. In 51 patients, a 4.7 Fr DJ stent was used after stone fragmentation, while in the remaining 53 cases, a 6 Fr stent was chosen. Between the two groups, general pain symptoms were evaluated using a visual pain scale at the end of the first postoperative week. The stone-free status was evaluated using non-contrast computed tomography (NCCT) after three months following surgery. Success was determined by either the complete clearance of the stones or the presence of small stone fragments (<3 mm).

Results

Using a visual pain scale, we compared the two groups' overall reports of pain (4.02±1.10 vs 4.81±1.53, p=0.006).  When we looked at the stone-free rates, the two groups were not significantly different in this regard (84.3% vs 74.5%, p=0.264). We found no statistically significant difference between the two groups in terms of postoperative fever, stent migration, or visits to the emergency room.

Conclusion

In spite of the fact that larger diameter stents resulted in more pain complaints for patients, they did not alter the long-term stone-free rates appreciably, as evidenced by our findings. In order to reduce the occurrence of unpleasant symptoms, a 4.7 Fr double-j stent may be preferable over a 6 Fr stent following flexible ureteroscopic surgery.

Keywords: Double-j stent diameter, renal stones, flexible ureterorenoscopy, stone free


ABSTRACT

Objective

This study's main goal was to evaluate the possible impact of different-sized double-J (DJ) stents on the pain and stone-free status following flexible ureteroscopic laser disintegration (fURS) of renal stones.

Methods

A total of 104 patients who underwent fURS for kidney stones were included in our study. In 51 patients, a 4.7 Fr DJ stent was used after stone fragmentation, while in the remaining 53 cases, a 6 Fr stent was chosen. Between the two groups, general pain symptoms were evaluated using a visual pain scale at the end of the first postoperative week. The stone-free status was evaluated using non-contrast computed tomography (NCCT) after three months following surgery. Success was determined by either the complete clearance of the stones or the presence of small stone fragments (<3 mm).

Results

Using a visual pain scale, we compared the two groups' overall reports of pain (4.02±1.10 vs 4.81±1.53, p=0.006).  When we looked at the stone-free rates, the two groups were not significantly different in this regard (84.3% vs 74.5%, p=0.264). We found no statistically significant difference between the two groups in terms of postoperative fever, stent migration, or visits to the emergency room.

Conclusion

In spite of the fact that larger diameter stents resulted in more pain complaints for patients, they did not alter the long-term stone-free rates appreciably, as evidenced by our findings. In order to reduce the occurrence of unpleasant symptoms, a 4.7 Fr double-j stent may be preferable over a 6 Fr stent following flexible ureteroscopic surgery.

Keywords: Double-j stent diameter, renal stones, flexible ureterorenoscopy, stone free