International Brazilian Journal of Urology (Mar 2021)

Patients with encrusted ureteral stents can be treated by a single session combined endourological approach

  • Roberto Iglesias Lopes,
  • Rodrigo Perrella,
  • Carlos Hirokatsu Watanabe,
  • Fabricio Beltrame,
  • Alexandre Danilovic,
  • Claudio Bovolenta Murta,
  • Joaquim Francisco de Almeida Claro,
  • Fabio Carvalho Vicentini

DOI
https://doi.org/10.1590/s1677-5538.ibju.2020.0511
Journal volume & issue
Vol. 47, no. 3
pp. 574 – 583

Abstract

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ABSTRACT Purpose: To describe our experience in the management of retained encrusted ureteral stents using a single session combined endourological approach. Materials and Methods: Patients with retained encrusted ureteral stents who had been submitted to a single session combined endourological approach from June 2010 to June 2018 were prospectively evaluated. Patients were divided according to the Forgotten-Encrusted-Calcified (FECal) classification. The stone burden, surgical intervention, number of interventions until stone free status, operation time, hospital stay, complications, stone analysis, and stone-free rate were compared between groups. ANOVA was used to compare numerical variables, and the Mann-Whitney or Chi-square test to compare categorical variables between groups. Results: We evaluated 50 patients with a mean follow-up of 2.9±1.4 years (mean±SD). The groups were comparable in terms of age, sex, laterality, BMI, comorbidities, ASA, reason for stent passage, and indwelling time. The stone burden was higher for grades IV and V (p=0.027). Percutaneous nephrolithotomy was the most common procedure (p=0.004) for grades IV and V. The number of procedures until the patients were stone-free was 1.92±1.40, and the hospital stay (4.2±2.5 days), complications (22%), and stone analysis (66% calcium oxalate) were similar between groups. The stone-free rate was lower in grades III to V (60%, 54.5%, and 50%). Conclusions: The endoscopic combined approach in the supine position is a safe and feasible technique that allows removal of retained and encrusted stents in a single procedure. The FECal classification seems to be useful for surgical planning.

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