Effect of Preoperative Double-J Ureteral Stenting before Flexible Ureterorenoscopy on Stone-free Rates and Complications

The effect of preoperative Double-J(DJ)ureteral stenting before flexible ureterorenoscopy(FURS)in the treatment for urinary stones was evaluated.We retrospectively enrolled 306 consecutive patients who underwent FURS from Jan.2014 to Dec.2017.All the patients were classified into two groups according to whether they had DJ ureteral stenting before FURS.Baseline characteristics(age,sex,stone location,stone size,surgical success rate,operation time,stone-free rate of the first day after surgery,stone-free rate of the first month after surgery,total complication rate)were compared using Chi-square test for categorical variables and Kruskal-Wallis test for continuous variables.In total,306 patients were included in this study.The group of DJ stenting before FURS included 203(66.3%)patients,and non-DJ stenting before FURS was observed in 103(33.7%)patients.The group of DJ stenting before FURS was significantly associated with a shorter operation time(53.8 vs.59.3 min,P<0.001),a higher stone-free rate of the first day after surgery(69.0%vs.51.5%,P=0.003).However,statistical significant differences were not found in the age,sex,stone location,stone size,surgical success rate,stone-free rate of the first month after surgery(89.2%vs.81.6%,P=0.065)and total complication rate(5.4%vs.9.7%,P=0.161)between the two groups.Preoperative DJ ureteral stenting before FURS could reduce the operation time and increase stone-free rate of the first day after surgery.However,it might not benefit the stone-free rate of the first month after surgery and reduce the complication rate.Preoperative DJ stenting should be not routinely performed.

The effect of perirenal fat stranding on infectious complications after ureterorenoscopy in patients with ureteral calculi

Objective:Perirenal fat stranding(PFS)is linear areas of soft-tissue attenuation in the perirenal space on non-contrast computed tomography.The present study aimed to investigate whether PFS is associated with infectious complications after ureterorenoscopy(URS)in patients with ureteral calculi in any location.Methods:The data of 602 patients with ureteral stones who underwent URS were analyzed retrospectively.The patients were divided into two groups as Group 1(PFS not detected)and Group 2(PFS detected).Gender,and age of patients,size,side,and location of the stone,operation time,double-J stent insertion status,perioperative ureter injury,postoperative infection after URS and related complications,and duration of hospital stay were compared.Results:While PFS was not detected in 530 patients,PFS was detected in 72 patients.The mean age,male/female ratio,side and localization of the stones,operation time,and perioperative insertion of the double-J after lithotripsy were statistically similar(p>0.05).The median stone diameter was smaller in Group 2(9 mm vs.8 mm)(p=0.033).Fever was observed in 30 and 38 patients in Group 1 and Group 2,respectively(p=0.0001).Urinary tract infection was detected in 24 and 27 patients in Group 1 and Group 2,respectively(p=0.0001).The urosepsis did not occur in any patients in Group 1,whereas 8(11.1%)patients in Group 2 experienced urosepsis(p=0.0001).Conclusion:According to the results of the present study,patients with ureteral stones accompanied by PFS are much more prone to ureteral injuries and infectious complications such as urinary tract infection,fever,and sepsis after URS.