The role of stenting in relieving loin pain following ureteroscopic stone therapy for persisting renal colic with hydronephrosis |
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Authors: | Mahmoud Mustafa |
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Institution: | (1) Department of Urology, Camlica Hayat Hospital, Alemdag Cad. No. 85, Uskuder-Istanbul, Turkey |
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Abstract: | Objective To prospectively define the role of the double J-stent placement following ureteroscopic stone therapy in providing a pain-free
postoperative period for patients with persisting loin pain and documented hydronphrosis. Material and methods The study cohort consisted of 27 patients (mean age: 38.59 years; range: 22–60 years) who had undergone ureteroscopic intervention
due to ureteral stone. All of the patients reported loin pain which did not respond to medical therapy associated with various
degrees of hydronephrosis documented by ultrasound and/or an excretory urogram. The patients were randomized to either a stented
(18 patients) or stentless (nine patients) group following semirigid ureteroscopy (7.5/12 Fr) for the treatment of ureteral
calculi (pneumatic lithotripsy). The mean diameter of the stones was 7.7 mm (range: 3–13 mm). Intra-operative balloon ureter
orifice dilatation was routinely performed. All patients were evaluated between 0 and 6 days postoperative for loin pain and
lower urinary tract symptoms. Results Nine patients had loin pain in the first few days following the operation and were in need of intramuscular and/or intravenous
analgesics. Of these, four were stented patients (4/18; 22.2%) and five were stentless patients (5/9; 55.5%). Lower urinary
tract symptoms were not clinically significant and did not affect the quality of life in terms of loin pain, with the exception
of one patient in whom the stent had dropped into the bladder. Conclusion We believe that stenting in patients with documented hydronephrosis manifesting in persisting renal colic is recommended.
As ureteroscopic therapy may aggregate the edema of ureter mucosa, double J-stent placement may play an important role in
offering patients a postoperative period free of loin discomfort. However, further prospective trials should be designed to
evaluate the criteria for stentless ureterorenoscopy. |
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Keywords: | Loin pain Ureter calculi Ureteroscopy |
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