Place of double-J stents in extracorporeal shock wave lithotripsy

Although double-J stents (DJS) are used to reduce complications following extracorporeal shock wave lithotripsy (ESWL), there has recently been a tendency to limit their use because of complications. We retrospectively reviewed 351 patients with renal stones larger than 30 mm to determine the effectiveness and the complications of DJS. While DJS were inserted prior to ESWL in 85 patients, 266 patients were treated without. The stone-free rate in the stented group was not significantly different from the non-stented group (31 and 30%). While the auxiliary treatment rate for the steinstrasse was 15% in the stented group, it was 18% in the non-stented group. Additionally, 4 of the stented patients (5%) were treated endoscopically because of encrustation or migration of the stent. Half of the patients in the stented group complained of mild bladder discomfort and disturbances which were relieved after removal of the DJS. We believe that DJS neither enhance stone passage nor reduce complications following ESWL, and therefore suggest their use only under certain conditions such as patients with solitary kidneys.