Survey on ureTEric draiNage post uncomplicaTed ureteroscopy (STENT)
Nikita R Bhatt1,2, Kenneth MacKenzie3,2, Taimur T Shah4,2
1Department of Urology Norfolk and Norwich University Hospital Norwich UK.
BJUI Compass
|April 27, 2022
Summary
Most urologists are willing to randomize patients in a trial comparing ureteric drainage versus no drainage after uncomplicated ureteroscopy. Current practices vary widely, supporting the need for a randomized controlled trial (RCT) to determine optimal ureteric drainage strategies.
Area of Science:
- Urology
- Surgical Innovation
- Clinical Trials
Background:
- Ureteroscopy and flexible ureterorenoscopy (URS/FURS) are common treatments for urinary tract stones.
- The necessity and optimal strategy for ureteric drainage following uncomplicated URS/FURS remain debated.
- Current urological practice exhibits significant variation regarding ureteric drainage post-procedure.
Purpose of the Study:
- To assess the feasibility of a randomized controlled trial (RCT) comparing ureteric drainage versus no drainage after uncomplicated URS/FURS.
- To evaluate the impact on patient-reported outcome measures (PROMs) and 30-day unplanned readmission rates.
- To understand current urologist practices and decision-making regarding ureteric drainage after uncomplicated URS/FURS (UU).
Main Methods:
- An international online survey of urologists was conducted.
- Respondents were asked about their willingness to participate in an RCT and their current practices regarding ureteric drainage after UU.
- Uncomplicated URS/FURS was clearly defined to standardize the study population.
Main Results:
- 81% of surveyed urologists expressed willingness to randomize patients in a proposed RCT.
- 92% of urologists reported routinely using ureteric drainage after UU, primarily to prevent edema and aid fragment passage.
- Significant variation exists in the perceived reasons for drainage and preferred duration (median 5 days).
Conclusions:
- The study supports the feasibility of conducting an RCT to investigate the benefits of avoiding ureteric drainage after UU.
- Findings highlight the need for evidence-based guidelines to standardize practice and improve patient outcomes.
- Further research is warranted to optimize ureteric drainage protocols following URS/FURS.
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