Retrograd İntrarenal Cerrahi Sonrası Double-J Stent Migrasyonunu Öngören Faktörler

Abstract

Objective: Although it is an effective and safe area of use, different complications may arise with the use of double-J stents (DJS). In this study, we aimed to determine the clinical results of DJS migration and risk factors predicting the occurrence of migration in patients who underwent retrograde intrarenal surgery (RIRS) for kidney stones. Material and Methods : The data of 1258 patients who underwent RIRS for kidney stones in our clinic between December 2013 and April 2020 and had DJS inserted after the procedure were retrospectively reviewed. Binary logistic regression analysis was performed to predict independent risk factors associated with DJS migration. Results: DJS migration was observed in 71 (5.6%) of 1258 patients. In group 1, stones located in the renal pelvis were statistically more common than calyceal stones (p = 0.003). While hydronephrosis is 70.4% in group 1; it was observed with a rate of 56.2% in group 2 (p = 0.019). Ureteral access sheath usage rate was 74.6% and 57.5% in group 1 and group 2, respectively (p = 0.004). While the modified Clavien-Dindo score in Group 1 was 2.2 ± 1.3; it was 0.2 ± 0.5 in group 2 (p <0.001). Stones located in the renal pelvis according to univariate and multivariate logistic regression analysis (odds ratio (OR) = 2.080, 95% Confidence Interval (CI): 1.277-3.388, p = 0.003), grade 3-4 hydronephrosis in the collecting system ( OR = 3.732, 95% CI: 1.783-7.809, p <0.001) and use of ureteral access sheath (OR = 2.387, 95% CI: 1.368-4.162, p = 0.002) are independent risk factors predicting DJS migration. Conclusions : Although DJS migration observed after RIRS is a rare complication, it is an important complication since it causes an additional procedure that requires general anesthesia, especially after proximal migration. It should be kept in mind in the postoperative period that DJS migration may occur in patients with high degree of hydronephrosis, stones in the renal pelvis, and in patients with a ureteral access sheath used in surgery.