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Extracorporeal shock wave lithotripsy for large renal calculi: The role of ureteral stents. A Randomized Trial

1991; Lippincott Williams & Wilkins; Volume: 145; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(17)38428-8

1527-3792

A.F. Bierkens, Ad J.M. Hendrikx, W.A.J.G. Lemmens, F.M.J. Debruyne,

Pediatric Urology and Nephrology Studies

No AccessJournal of Urology1 Apr 1991Extracorporeal shock wave lithotripsy for large renal calculi: The role of ureteral stents. A Randomized Trial Alexander F. Bierkens, AD J.M. Hendrikx, Wim A.J.G. Lemmens, and Frans M.J. Debruyne Alexander F. BierkensAlexander F. Bierkens , AD J.M. HendrikxAD J.M. Hendrikx , Wim A.J.G. LemmensWim A.J.G. Lemmens , and Frans M.J. DebruyneFrans M.J. Debruyne View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)38428-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Ureteral stents reduce complications after extracorporeal shock wave lithotripsy (ESWL* Dornier Medical Systems, Inc., Marietta, Georgia. ) and contribute to successful stone passage. However, some reports note complications that are attributed to indwelling ureteral stents. We randomized 64 patients with large renal calculi (stone burden more than 200mm.2) for in situ treatment or treatment with a prophylactically inserted stent. We used a 6Ch round stent with single-coiled ends or a triangular shaped stent with double-coiled ends. Patients were treated with a Siemens Lithostar lithotriptor.† After 3 months we evaluated the results of treatment and post-ESWL morbidity. Of the in situ group (23 patients) treatment complications consisted of fever in 3, pyelonephritis in 1 and steinstrasse in 3. After 3 months 8 patients (35%) were free of stones. Of the stented population (41 patients) treatment complications consisted of fever in 7, pyelonephritis in 1, steinstrasse in 6 and bladder discomfort in almost half of the patients. Stent calcification and stent migration were also seen in 7 and 10 patients, respectively. Calcified stents had been in situ longer than noncalcified stents. The round stents migrated and calcified more often than the more rigid triangular stents. After 3 months 18 of the stented patients were stone-free (44%). We conclude that ureteral stents do not reduce post-ESWL complications. They are clearly associated with morbidity and do not improve stone passage markedly. Therefore, patients with a stone burden of more than 200mm.2 should be treated in situ without auxiliary stenting. © 1991 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByPengfei S, Min J, Jie Y, Xiong L, Yutao L, Wuran W, Yi D, Hao Z and Jia W (2018) Use of Ureteral Stent in Extracorporeal Shock Wave Lithotripsy for Upper Urinary Calculi: A Systematic Review and Meta-AnalysisJournal of Urology, VOL. 186, NO. 4, (1328-1335), Online publication date: 1-Oct-2011.Seitz C, Fritsche H, Siebert T, Martini T, Wieland W, Pycha A and Burger M (2018) Novel Electromagnetic Lithotriptor for Upper Tract Stones With and Without a Ureteral StentJournal of Urology, VOL. 182, NO. 4, (1424-1429), Online publication date: 1-Oct-2009.GERBER R, NITZ C, STUDER U and DANUSER H (2018) SPIRAL STENT VERSUS STANDARD STENT IN PATIENTS WITH MIDSIZE RENAL STONES TREATED WITH EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY: WHICH STENT WORKS BETTER? A PROSPECTIVE RANDOMIZED TRIALJournal of Urology, VOL. 172, NO. 3, (965-966), Online publication date: 1-Sep-2004.CHANDHOKE P, BARQAWI A, WERNECKE C and CHEE-AWAI R (2018) A Randomized Outcomes Trial of Ureteral Stents for Extracorporeal Shock Wave Lithotripsy of Solitary Kidney or Proximal Ureteral StonesJournal of Urology, VOL. 167, NO. 5, (1981-1983), Online publication date: 1-May-2002.CHEN Y, CHEN J, WONG W, YANG S, HSIEH C and WANG C (2018) Is Ureteral Stenting Necessary After Uncomplicated Ureteroscopic Lithotripsy? A Prospective, Randomized Controlled TrialJournal of Urology, VOL. 167, NO. 5, (1977-1980), Online publication date: 1-May-2002.DENSTEDT J, WOLLIN T, SOFER M, NOTT L, WEIR M and D'A. HONEY R (2018) A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL COMPARING NONSTENTED VERSUS STENTED URETEROSCOPIC LITHOTRIPSYJournal of Urology, VOL. 165, NO. 5, (1419-1422), Online publication date: 1-May-2001.PACE K, WEIR M, TARIQ N and HONEY R (2018) LOW SUCCESS RATE OF REPEAT SHOCK WAVE LITHOTRIPSY FOR URETERAL STONES AFTER FAILED INITIAL TREATMENTJournal of Urology, VOL. 164, NO. 6, (1905-1907), Online publication date: 1-Dec-2000.Monga M, Klein E, Castaneda-Zuniga W and Thomas R (2018) The Forgotten Indwelling Ureteral Stent: A Urological DilemmaJournal of Urology, VOL. 153, NO. 6, (1817-1819), Online publication date: 1-Jun-1995.Mobley T, Myers D, Grine W, Jenkins J and Jordan W (2018) Low Energy Lithotripsy with the Lithostar: Treatment Results with 19,962 Renal and Ureteral CalculiJournal of Urology, VOL. 149, NO. 6, (1419-1424), Online publication date: 1-Jun-1993. Volume 145Issue 4April 1991Page: 699-702 Advertisement Copyright & Permissions© 1991 by The American Urological Association Education and Research, Inc.Keywordslithotripsykidney calculiMetricsAuthor Information Alexander F. Bierkens More articles by this author AD J.M. Hendrikx More articles by this author Wim A.J.G. Lemmens More articles by this author Frans M.J. Debruyne More articles by this author Expand All Advertisement Loading ...