Effect of JJ Stent on Outcomes of Extracorporeal Shockwave Lithotripsy of Renal Stones around 2 cm

Abstract

Abstract Background Urolithiasis is a common problem in Egypt as it lies within the stone belt region extending from Indonesia to Egypt. Economic and dietary factors, dehydration, exposure to heat and possible genetic factors. Urolithiasis is one of the most common problems encountered by urologists. Many factors affect Stone formation like geographical, climatic, ethnic, dietary and genetic factors. The recurrence rate is determined by the primary etiology of stones formation. Aim of the Work Evaluation of the role of JJ stent in enhancing the passage of fragments in patients undergoing extracorporeal shockwave lithotripsy (ESWL) for renal stones with size around 2 cm. Patients and Methods This randomized controlled clinical trial was conducted on 90 patients in the period from December 2021 to July 2022 with age ranged from 24 – 60 years with mean±SD of 44.21 ± 10.99 years; they were 28 females (31.1%) and 62 males (68.9%) and randomly divided into two groups: Group (I): Patients without JJ stent consists of 45 patients & Group (II): Patients with JJ stent consists of 45 patients. Results The analysis of our study results showed no statically significant difference between the two groups regarding SFRs (95.6% in group I & 93.3% in group II), time to SFRs (mean±SD 1.05 ± 0.55 month in group I & 1.20 ± 0.59 month in group II), number of sessions of ESWL (2.11 for group I & 2.37 for group II), auxillary procedures (Two patients in group I (4.4%) 1 patient had PCNL & 1 patient had URS due to steinStrasse 2.2%) & Three patients in group II (6.7%) failed ESWL and had PCNL), number of ER visits (in group I 46.7% & in group II 40 % had attended at least once for the ER, analgesics consumption (In group I 77.8% & In group II 84.4%) & laboratory tests changes like Hb drob between pre & post ESWL in the two groups (-0.02 ± 0.04 & -0.11 ± 0.08 in group I & group II respectively) & the amount of increase in serum creatinine level (post – pre) was found 0.07 ± 0.03 in patients without JJ stent and 0.03 ± 0.04 in patient with JJ stent. Conclusion Routine JJ stent fixation before extracorporeal shock wave lithotripsy in management of renal stones around 2cm is unnecessary because it doesn’t improving free stone rate or enhancing the passage of the fragments during ESWL.