Effectiveness Of Double J Stent With Extracorporeal Shockwave Lithotripsy: An Analysis Of Stone-Free Rates
DOI:
https://doi.org/10.46568/bios.v4i2-3.97Keywords:
Double J stent, Renal Stone, Extracorporeal Shockwave lithotripsyAbstract
Introduction: Preservation of renal function and integrity is of profound importance and therefore renders stent-related symptoms a secondary concern. The usage of DJ stent is known for decades to support stone removal, this study aims to assess the effect of DJ stent after extracorporeal shock wave lithotripsy for stone removal and DJ stent-related complications in adult patients. Methods: This is a prospective, comparative study, Patients were selected after being diagnosed with established radiological evidence of a single radio-opaque stone ≤ 2 cm. The presence of the visible radio-opaque shadow post-procedure indicated residual stones and negative results. Primary follow-up was recommended after 2 weeks post-procedure and participants were inquired about all the anticipated complications, data was entered on SPSS version 23.0 for analysis. The chi-square test was applied to assess the significance and a p-value ≤ 0.05 was deemed significant for our results. Results: The sample size of the study was 150, sorted equally into two separated groups categorized by presence and absence of DJ stent after ESWL, stone size was almost similar to avoid any confounding factor with the mean value of 1.24 ± 0.2 in group A and 1.6 ± 0.1 in group B, with a p-value of 0.05. Hematuria was categorized within mild 6(4%) & 7(4.6%), moderate 6(4%) & 5(3.3%) while gross hematuria was reported in 1(0.6%) & 2(1.3%) in group A and B respectively. Conclusion: This study concluded that using a DJ stent with ESWL does not help in the stone passage or improve stone-free rates of stone removal after breaking the calculi with shockwave lithotripsy.
References
Kim KW, Choi YH, Lee SB, Baba Y, Kim HH, Suh SH. Analysis of Urine Flow in Three Different Ureter Models. Comput Math Methods Med. 2017;2017:5172641.
Khan SR, Pearle MS, Robertson WG, Gambaro G, Canales BK, Doizi S, Traxer O, Tiselius HG. Kidney stones. Nat Rev Dis Primers. 2016;2:16008. doi: 10.1038/nrdp.2016.8. PMID: 27188687; PMCID: PMC5685519.
Niels-Peter B, Abbas F, Khan R, Talati JJ, Afzal M, Rizvi I. The prevalence of silent kidney stones: an ultrasonographic screening study. Journal of the Pakistan Medical Association. 2003;53(1):24.
Imtiaz S, Salman B, Qureshi R, Drohlia MF, Ahmad A. A review of the epidemiology of chronic kidney disease in Pakistan: A global and regional perspective. Saudi Journal of Kidney Diseases and Transplantation. 2018;29(6):1441.
Grases F, Costa-Bauzá A, Ramis M, Montesinos V, Conte A. Simple classification of renal calculi closely related to their micromorphology and etiology. Clinica Chimica Acta. 2002;322(1-2):29-36.
Shah SR, Desai MD, Panchal L. Identification of content descriptive parameters for classification of renal calculi. International Journal of Signal & Image Processing. 2010;1(4).
Kallidonis P, Liourdi D, Liatsikos E. Medical treatment for renal colic and stone expulsion. European Urology Supplements. 2011;10(5):415-22.
Srisubat A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane database of systematic reviews. 2014(11).
Ghaffar a. Dj-stenting: efficacy in the management of obstructive uropathy. The professional medical journal. 2007;14(01):56-9.
Bai F, Wu H, Zhang N, Chen J, Wen J. The feasibility, safety, and efficacy of the preemptive indwelling of double-J stents in percutaneous nephrolithotomy surgery: A randomized controlled trial. Urology Journal. 2020;17(3):232-6.
Ahallal Y, Khallouk A, El Fassi MJ, Farih MH. Risk factor analysis and management of ureteral double-j stent complications. Reviews in urology. 2010;12(2-3):e147.
Lange D, Bidnur S, Hoag N, Chew BH. Ureteral stent-associated complications—where we are and where we are going. Nature Reviews Urology. 2015;12(1):17-25.
LeRoy AJ, Williams Jr HJ, Segura JW, Patterson DE, Benson Jr RC. Indwelling ureteral stents: percutaneous management of complications. Radiology. 1986;158(1):219-22.
Skolarikos A, Alivizatos G, de la Rosette J. Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. European urology. 2006;50(5):981-90.
Sulaiman MN, Buchholz NP, Clark PB. The role of ureteral stent placement in the prevention of Steinstrasse. Journal of endourology. 1999;13(3):151-5.
Pengfei S, Min J, Jie Y, Xiong L, Yutao L, Wuran W, Yi D, Hao Z, Jia W. Use of ureteral stent in extracorporeal shock wave lithotripsy for upper urinary calculi: a systematic review and meta-analysis. The Journal of urology. 2011;186(4):1328-35.
Cornelius J, Zumbühl D, Afferi L, Mordasini L, Di Bona C, Zamboni S, Moschini M, Pozzi E, Salonia A, Mattei A, Danuser H. Immediate shockwave lithotripsy vs delayed shockwave lithotripsy after urgent ureteral stenting in patients with ureteral or pyeloureteral urolithiasis: a matched-pair analysis. Journal of Endourology. 2021;35(5):721-7.
Pansota MS, Shafqat S, Tabassum SA. Comparison of the success of extracorporeal shock wave lithotripsy (ESWL) with and without DJ Stenting In Proximal Ureteric Stone. Journal of University Medical & Dental College. 2020;11(2):21-6.
Musa, A.A.K. Use of double-J stents prior to extracorporeal shock wave lithotripsy is not beneficial: results of a prospective randomized study. Int Urol Nephrol 40, 19-22 (2008). https://doi.org/10.1007/s11255-006-9030-8
Mudassar Saeed Pansota, Sharmeen Shafqat, Shafqat Ali Tabassum. Comparison of the success of extracorporeal shock wave lithotripsy (ESWL) with and without DJ stenting in proximal ureteric stone . JUMDC [Internet]. 2020Jul.10 [cited 2022May8];11(2):21-6. Available from: http://jumdc.com/index.php/jumdc/article/view/303
Pengfei S, Min J, Jie Y, Xiong L, Yutao L, Wuran W, Yi D, Hao Z, Jia W. Use of ureteral stent in extracorporeal shock wave lithotripsy for upper urinary calculi: a systematic review and meta-analysis. The Journal of urology. 2011;186(4):1328-35.
El-Assmy A, El-Nahas AR, Sheir KZ. Is pre-shock wave lithotripsy stenting necessary for ureteral stones with moderate or severe hydronephrosis?. The Journal of urology. 2006;176(5):2059-62.
Wang H, Man L, Li G, Huang G, Liu N, Wang J. Meta-analysis of stenting versus non-stenting for the treatment of ureteral stones. PloS one. 2017;12(1):e0167670.
Ghoneim IA, El-Ghoneimy MN, El-Naggar AE, Hammoud KM, El-Gammal MY, Morsi AA. Extracorporeal shock wave lithotripsy in impacted upper ureteral stones: a prospective randomized comparison between stented and non-stented techniques. Urology. 2010 Jan 1;75(1):45-50.
Bierkens AF, Hendrikx AJ, Lemmens WA, Debruyne FM. Extracorporeal shock wave lithotripsy for large renal calculi: the role of ureteral stents. A randomized trial. The Journal of urology. 1991;145(4):699-702.
Dellis A, Joshi HB, Timoney AG, Keeley Jr FX. Relief of stent related symptoms: review of engineering and pharmacological solutions. The Journal of urology. 2010;184(4):1267-72.
Geavlete P, Georgescu D, Mulțescu R, Stanescu F, Cozma C, Geavlete B. Ureteral stent complications–experience on 50,000 procedures. Journal of Medicine and Life. 2021;14(6):769.
Sigdel B, Shrestha S, Maskey P. Forgotten DJ stent presenting with emphysematous pyelonephritis: A life threatening complication. International Journal of Surgery Case Reports. 2021;87:106405.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 BioSight
This work is licensed under a Creative Commons Attribution 4.0 International License.
