Category: Clinical Stones: Ureteroscopy

MP24-3 - Association between lower urinary tract symptoms and double J stent use in uncomplicated ureterolithotripsy.

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective :

The use of a double J stent (DJS) after a non-complicated ureterolithotripsy is controversial; literature varies among symptoms and complications in each group. Few studies with standardized scales to clarify lower urinary tract symptoms (LUTS) have been performed.

Our primary objective was to determine the association between LUTS and DJS in patients after uncomplicated ureterolithotripsy.

Methods :

Prospective cohort; 82 patients of lower and middle third uncomplicated ureterolithotripsy were divided into two groups; with and without DJS; follow up was  performed during 14 days; LUTS were established using the urinary symptom section of the Ureteral Stent Symptom Questionnaire(USSQ); other complications such as body pain, post-surgical renal colic, fever, visit to the emergency room, need of reoperation, opioid requirement and surgical time were measured.

Sample size was calculated by mean difference of the urinary symptom section at 7 days; 28.69(±10.78) in patients with DJS vs 23.3 (±5.8) in patients without stent but with symptoms due to several urological pathologies.

Statistical analysis was performed using Mann-Whitney´s U, Relative Risks (RR) with confidence intervals of 95%(CI95%) and a multivariate analysis.

Results :

Mean age was 39.7 (±11.9), surgical time was higher for patients with DJS, 56 (49-67) vs 46 (40-51) minutes, p(0.001).

Gender, age, body mass index, stone size and stone density were similar between groups<./p>

The RR (CI95%) for presenting moderate and severe symptoms at 7 days in the DJS group was of 4.5 (2.3-9.1).

The correlation between DJS and LUTS was R=0.62; and in the multivariate analysis the main predictor for LUTS was the DJS (p 0.000) when adjusted for age, gender, body mass index, stone density and surgical time.

No statistical differences in complications were shown between groups<./p>

Conclusions :

Placement of DJS in uncomplicated ureterolithotripsy is the main factor associated with moderate and severe LUTS.
No statistical differences in post-surgical complications are shown between groups<./p>

Pedro Avila Herrera

Urologist Hospital General CMN La Raza
Endourology Society / AUA / Colegio Mexicano de Urología
Mexico City, Distrito Federal, Mexico

Jorge Moreno Palacios

Mexico City, Distrito Federal, Mexico

Miguel González Domínguez