MP75-05 FAST TRACK STENT STUDY (FAST): SHORT TERM EXTERNAL URETER STENTING SHOWS SIGNIFICANT BENEFIT IN COMPARISON TO ROUTINE DJ STENT PLACEMENT AFTER URETERORENOSCOPIC STONE EXTRACTION – A PROSPECTIVE-RANDOMIZED TRAIL

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy VII1 Apr 2017MP75-05 FAST TRACK STENT STUDY (FAST): SHORT TERM EXTERNAL URETER STENTING SHOWS SIGNIFICANT BENEFIT IN COMPARISON TO ROUTINE DJ STENT PLACEMENT AFTER URETERORENOSCOPIC STONE EXTRACTION – A PROSPECTIVE-RANDOMIZED TRAIL Peter Bach, Alina Reicherz, Lisa Dahlkamp, Nicolas von Landenberg, Rein-Jueri Palisaar, Joachim Noldus, and Christian von Bodman Peter BachPeter Bach More articles by this author , Alina ReicherzAlina Reicherz More articles by this author , Lisa DahlkampLisa Dahlkamp More articles by this author , Nicolas von LandenbergNicolas von Landenberg More articles by this author , Rein-Jueri PalisaarRein-Jueri Palisaar More articles by this author , Joachim NoldusJoachim Noldus More articles by this author , and Christian von BodmanChristian von Bodman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2153AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Does short-term ureter stenting using an external ureter catheter (UC) for 6 hours following ureterorenoscopic stone extraction (URS) provide an equivalent outcome in comparison to postoperative double-J (DJ) ureter stenting? METHODS Between 08/2014 and 08/2015, 141 patients initially treated with a DJ insertion for 7 days were prospectively randomized to UC for 6 hours vs DJ insertion for 3-5 days after stone extraction via URS (incl. flexible URS) in a single academic center. Exclusion criteria were acute urinary tract infection, a solitary kidney or a stone mass more than 25mm. Study endpoints were ureter-stent related symptoms and pain assessed by a validated questionnaire (USSQ) and visual analogue scale (VAS) before and 3-5 weeks after surgery. Parameters of both groups were compared using unpaired t-test. Level of significance was p<0.05. BMI, stone size, age, and need for analgetics, reintervention rate and comorbidities were recorded. RESULTS Endoscopic procedures performed by 9 surgeons resulted in more than 90% stone removal in all cases (n=141) in a mean operation time of 24 minutes (range 5-63 min). Groups did not differ in mean age (48 years), mean BMI (28.1) and stone size (5.4 mm). Patients, who received short-term UC, showed a significant higher quality of life (USSQ) compared to patients with a long-term DJ: In the UC group the urinary index score was significantly lower (16.8 vs. 27.8; p <0.0001) as well as the pain score (9.7 ± 1.3 vs. 20.2 ± 1.5; p<0.0001) and general health index (15.3 ± 0.7 vs. 8.5 ± 0.6; p<0.0001). Consultation of a physician and antibiotic treatment were rarely needed (1.3 ± 0.1 vs. 1.6 ± 0.1; p=0.027). The UC study group returned to work earlier (3.0 ± 0.8 days) compared to the DJ study group (7.0 ± 0.9 days; p<0.0009). Furthermore, most of the UC population (88.3%) recommended treatment and would prefer an UC in case of another stone treatment in the future. Only two patients of the UC study group reported prolonged complaints lasting 2 days. No re-intervention was needed in both groups during the follow-up of 6 weeks. CONCLUSIONS In patients who had a DJ prior to secondary ureteroscopic stone removal postoperative short-term ureteral stenting should be standard of care rather than routine DJ insertion. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1005 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Peter Bach More articles by this author Alina Reicherz More articles by this author Lisa Dahlkamp More articles by this author Nicolas von Landenberg More articles by this author Rein-Jueri Palisaar More articles by this author Joachim Noldus More articles by this author Christian von Bodman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...