Presentation Authors: Thilo Westhofen*, Christian G. Stief, Frank Strittmatter, München, Germany
Introduction: IntroductionUreterorenoscopy (URS) is a feasible, safe and efficient treatment for patients with nephrolithiasis. International guidelines do not explicitly recommend routine pre-stenting before ureterorenoscopy. Stone free rate and perioperative complications however can be positively influenced by prestenting._x000D_
Objective:To compare perioperative outcomes of patients treated for nephrolithiasis using ureterorenoscopy with and without prestenting.
Methods: Method:We retrospectively evaluated 342 patients treated for nephrolithiasis with URS at a single urological department from 2016 to 2017. Patients with renal stones up to 12mm size, detected with non-contrast-enhanced CT were matched for size of renal stone. Assessment of stone free rates and perioperative complications (using Clavien Dindo classification) after ureterorenoscopy with stone removal for patients with (n=147) and without (n=195) prestenting prior to the operation was performed.
Results: ResultsPatients with a median stone size of 8mm (IQR 5-8mm) treated with and without prestenting prior to URS showed no significant differences for parameters such as age (median 51 vs. 50) or BMI (median 27.2 vs.26.0) (each ,p>0.05).The median operation time of 51min (IQR 34-77) for patients with prestenting was significantly longer than for patients without prestenting (median 45 min; IQR 19-66) (p < 0.05)No significant difference in perioperative radiation exposure (dose area product) was determined for patients with (median 2.61 cGy.cm2; IQR 0.55-432.00) and without (median 3.43 cGy.cm2; IQR 0.59-497.00) prestenting.Postoperative stone free rates were significantly higher for patients with prestenting (87.76% vs. 60.25%)Overall perioperative complication rates (2.72% vs. 6.21%) as well as severe complications (>Clavien Dindo II â€“ 0.68% vs. 1.24%) were significantly lower for patients with prestenting.
Conclusions: ConclusionPrestenting prior to URS with stone removal for nephrolithiasis significantly increases stone free rates.With longer operation time after prestenting, radiation exposure was not significantly longer. Perioperative complications were significantly less after prestenting.