The Management of Reno-Ureteral Lithiasis - from Emergency Presentation to Definitive Treatment
P Geavlete1,2,3, A Plesuvescu2, F Stanescu2
1"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Maedica
|June 2, 2023
Summary
Emergency pre-stenting followed by secondary intervention for kidney stones is safe and effective. Flexible ureteroscopy demonstrated the highest stone-free rate in this study.
Area of Science:
- Urology
- Endourology
- Nephrolithiasis Management
Background:
- This retrospective study evaluated the efficacy of secondary interventions for renal and ureteral lithiasis following emergency pre-stenting.
- A total of 149 patients presenting with acute renal pathology were included, undergoing initial double-J stent placement before definitive treatment.
Discussion:
- The study compared stone-free rates for semirigid ureteroscopy, flexible ureteroscopy (F-URS), combined ureteroscopy, and percutaneous nephrolithotomy (PCNL).
- Encrusted or obstructed stents were noted in a small percentage of cases, highlighting potential complications.
- Mean operative time was 23 minutes with no major incidents reported.
Key Insights:
- Flexible ureteroscopy (F-URS) achieved the highest stone-free rate at 90.6%.
- Semirigid ureteroscopy yielded an 86% stone-free rate, while combined procedures had a 90.24% rate.
- Percutaneous nephrolithotomy (PCNL) showed a lower stone-free rate of 75%.
Outlook:
- Emergency pre-stenting appears to be a safe and valuable strategy prior to definitive stone removal.
- Flexible ureteroscopy is a highly effective secondary intervention for achieving stone-free status in reno-ureteral lithiasis.
- Further research could explore optimizing pre-stenting protocols and comparing long-term outcomes of different secondary interventions.
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