The impact of preoperative ureteral stent duration on retrograde intrarenal surgery results: a RIRSearch group study


Şahin M. F., Akgül M., Çakır H., Özman O., Başataç C., Çınar Ö., ...Daha Fazla

Urolithiasis, cilt.52, sa.1, 2024 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 52 Sayı: 1
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1007/s00240-024-01620-0
  • Dergi Adı: Urolithiasis
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: Duration, Postoperative urinary tract infection, Preoperative JJ stent, Retrograde intrerenal surgery
  • Çanakkale Onsekiz Mart Üniversitesi Adresli: Evet

Özet

A JJ stent placed before retrograde intrarenal surgery (RIRS) may ease the procedure. However, it is important to note that a prolonged duration of double J stent (DJS) placement before RIRS may increase the risk of postoperative urinary tract infection (UTI). Various publications have established this association, although the duration of the DJS before surgery is scarce. Our study investigates the relationship between the pre-stenting period and postoperative UTI and establishes a cut-off period to minimize this risk. We included a total of 500 cases with preoperative DJS prior to RIRS. The patients were divided into five groups according to their preoperative stenting duration (Group 1: 0–15 days; Group 2: 16–30 days; Group 3: 31–45 days; Group 4: 46–60 days; Group 5: >60 days). Demographic and clinical data of the patients, stone properties, operation data, perioperative and postoperative complications (including fever and UTI), hospitalization time, and stone-free rates (SFR) were compared. The groups contained 53, 124, 102, 63, and 158 patients. The demographics of the patients in each group were similar. There was no statistically significant difference between DJS duration, perioperative/postoperative complications, and SFR, except for the ureteral access sheath (UAS) insertion rate. (p = 0.001). The postoperative fever/UTI rate was the lowest in Group 1 (p = 0.046) compared to other durations. Stent duration does not impact SFR. Longer stents enhance UAS insertion success but increase postoperative infection risk. Our results suggest that RIRS should be performed within two weeks, ideally 20 days following stent insertion, to minimize postoperative infection risk.