Stenting or not prior to shock wave lithotripsy for upper and middle pole renal stone of 10-20mm

Stojanoski, Ivica and Stavridis, Sotir and Krstev, Toni and Bozinoska Beaka, Gordana and Egevit, Kadrii (2023) Stenting or not prior to shock wave lithotripsy for upper and middle pole renal stone of 10-20mm. Macedonian Journal of Anaes thesia, 7 (1). pp. 12-20. ISSN 2545-4366

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Abstract

Objective: To evaluate the impact of routine ureteral stenting before SWL treatment for upper
and middle pole stone of 10-20mm in size, on the prevention of post-SWL complications and to
confirm whether this procedure affects the improvement of the success rate.
Methods: Our study was retrospective study, carried out in GH “8th of September” - Skopje
in the period from March 2022 to November 2022 with an analysis of the medical data of 41
patients treated with extracorporeal shock wave lithotripsy (SWL) for stones in the upper and
the middle pol of 10 to 20mm in size. The first group included 13 patients treated with SWL, with
a ureteral JJ stent placed before treatment, and the second group included 28 patients without a
ureteral JJ stent. Patients were treated with an extracorporeal lithotripter of the third generation
of electromagnetic lithotripters (Lithoskop®, Siemens Medical Systems, Erlangen, Germany).
Both groups were compared in stone size, stone clearance pain, steinstrasse, UTI, lower urinary
tract symptoms (LUTS), hematuria and number of SWL sessions.
Results: The mean size of the stone in the group of patients with ureteral JJ stent was statistically
significantly greater compared to the non-stented group (p=0.000012). The average number of
sessions and re-treatment rate was significantly higher in patients with a ureteral JJ stent (p=0.006).
There was a statistically significant difference in the energy used for stone disintegration in both
groups (p=0.0028). Stone clearance occurred in 76.92% patients in stented group and 85.71%
in non-stented group. In stented group lower urinary tract symptoms were found in 33.7 versus
0% in a non-stented group. “Steinstrasse” developed in 7.69% of the patients with JJ stent and in
7.14% patients without JJ stent. Regarding pain, lower urinary tract infections and hematuria,
there was no statistically significant correlation between the two groups (p=0.84 p=0.14 p=0.17).
Conclusion: Routine stenting for upper and middle pole stone of 10-20mm in size before
SWL should not be recommended because it does not prevent the formation of a “stainstrasse”,
does not improve the success rate and causes irritative symptoms of the lower urinary tract.
Key Words: pre-stenting, stainstrasse, SWL, ureteral JJ stent.

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Ivica Stojanoski
Date Deposited:	20 Feb 2024 07:15
Last Modified:	20 Feb 2024 07:15
URI:	https://eprints.ugd.edu.mk/id/eprint/33675

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