Ureteral Stenting and Urinary Stone Management: A Systematic Review

No AccessJournal of UrologyReview article1 Feb 2008Ureteral Stenting and Urinary Stone Management: A Systematic Review George Haleblian, Kittinut Kijvikai, Jean de la Rosette, and Glenn Preminger George HaleblianGeorge Haleblian Comprehensive Kidney Stone Center, Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina More articles by this author , Kittinut KijvikaiKittinut Kijvikai Department of Urology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands More articles by this author , Jean de la RosetteJean de la Rosette Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Financial interest and/or other relationship with Oncura, BSC and American Medical Systems. More articles by this author , and Glenn PremingerGlenn Preminger Comprehensive Kidney Stone Center, Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.09.026AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Ureteral stents are widely used in many urological procedures. We evaluated the recent literature, providing an update on materials and stent designs, and indications for stent placement and stent complications, including the management of such stent related problems. Materials and Methods: A thorough literature search on ureteral stents was performed. Pertinent new and review/updated articles published in the English literature from 2000 through 2006 were systematically reviewed. Results: Following uncomplicated ureteroscopy or shock wave lithotripsy routine stenting does not appear to affect the stone-free rate. However, stent related morbidity is often seen. Patients at greatest risk for complications are those undergoing bilateral stentless ureteroscopy, those with recent or recurrent urinary tract infections and pregnant patients. The placement of indwelling stents in these patients should be considered. The development of stent materials and designs has been directed toward decreasing stent related morbidity, such as pain, discomfort, bladder irritability, infection and encrustation. Changes in stent design and materials show great promise. Initial evaluations suggest improvements in patient comfort as well as decreased encrustation. Forgotten stents can lead to significant morbidity as a result of severe encrustation. Most cases can be managed endoscopically, often requiring multiple procedures. Conclusions: Stenting is not mandatory after uncomplicated simple ureteroscopy and shock wave lithotripsy. Patients with stents seem to have significantly more bladder and lower urinary tract symptoms than those in whom stents are not placed. However, there is a subgroup of patients who likely benefit from stenting following a procedure because of the increased risk of complications. The ideal ureteral stent biomaterial has yet to be discovered and an area of promising development is the drug eluting stent to prevent infection and encrustation. References 1 : The forgotten indwelling ureteral stent: a urological dilemma. J Urol1995; 153: 1817. Link, Google Scholar 2 : Ureteral stents and their use in endourology. Curr Opin Urol2002; 12: 217. Google Scholar 3 : Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol2003; 169: 1060. 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Link, Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byPais V, Smith R, Stedina E and Rissman C (2018) Does Omission of Ureteral Stents Increase Risk of Unplanned Return Visit? A Systematic Review and Meta-AnalysisJournal of Urology, VOL. 196, NO. 5, (1458-1466), Online publication date: 1-Nov-2016.Althaus A, Li K, Pattison E, Eisner B, Pais V and Steinberg P (2018) Rate of Dislodgment of Ureteral Stents When Using an Extraction String after Endoscopic Urological SurgeryJournal of Urology, VOL. 193, NO. 6, (2011-2014), Online publication date: 1-Jun-2015.Watson J, Chang C, Pattaras J and Ogan K (2018) Same Session Bilateral Ureteroscopy is Safe and EfficaciousJournal of Urology, VOL. 185, NO. 1, (170-174), Online publication date: 1-Jan-2011.Weedin J, Coburn M and Link R (2018) The Impact of Proximal Stone Burden on the Management of Encrusted and Retained Ureteral StentsJournal of Urology, VOL. 185, NO. 2, (542-547), Online publication date: 1-Feb-2011.Wirtz P, Krambeck A, Handa S, Terry C and Lingeman J (2018) Contralateral Ureteroscopy Performed at Percutaneous Nephrolithotomy: A Unique Evaluation of Stone-Free RatesJournal of Urology, VOL. 184, NO. 6, (2378-2382), Online publication date: 1-Dec-2010.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. Volume 179Issue 2February 2008Page: 424-430 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsureterstentsureteroscopylithotripsycomplicationsMetricsAuthor Information George Haleblian Comprehensive Kidney Stone Center, Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina More articles by this author Kittinut Kijvikai Department of Urology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands More articles by this author Jean de la Rosette Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Financial interest and/or other relationship with Oncura, BSC and American Medical Systems. More articles by this author Glenn Preminger Comprehensive Kidney Stone Center, Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina More articles by this author Expand All Advertisement PDF downloadLoading ...