Should the Double-J Stent Be Removed Endoscopically after a Ureteroscopic Stone Surgery?

Abstract

Objective:Ureterorenoscopic stone surgery (USS) is the primary method of ureteral stone treatment. Double-J (JJ) stenting is an integral part of a USS, and most urologists prefer to use it without an extraction string. The probable reason for such preference could be the lack of reliable and sufficient data on JJ stent use with an extraction string.Materials and Methods:A total of 177 patients who underwent USS were divided into four groups: Group 1 men (JJ stent was manually removed), group 2 men (JJ stent was cystoscopically removed), group 3 women (JJ stent was manually removed), and group 4 women (JJ stent was cystoscopically removed). We investigated the impact of two different JJ stent removal techniques on pain perception, lower urinary tract symptoms (LUTS), depressive symptomatology, complications, and cost.Results:Compared to groups 1 and 3, the mean surgery times were higher in groups 2 and 4 (p=0.001). Preoperative LUTS scores were similar in all groups (p>0.05). Postoperative pain scores in groups 3 and 4 were similar (p=0.06), but they were lower in group 1 than in group 2 (p=0.004). Postoperative Beck depression inventory scores were lower in groups 1 and 3 (p<0.02). The total cost of USS was 28.5% higher in groups 2 and 4 compared to groups 1 and 3.Conclusion:It is concluded that JJ stent removal with an extraction string is a reliable method with low treatment costs that does not adversely affect surgical outcomes.

Keywords

• cost effectivity
• double-j stent
• extraction string
• ureterorenoscopy
• pain