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Stent use with extracorporeal shock wave lithotripsy
1Harvard Program in Urology (Longwood Area), Beth Israel Hospital, Boston, MA.
Journal of Endourology
|April 1, 1993
Summary
Ureteral stenting is frequently used for kidney stone treatment but offers no benefit for stones smaller than 2 cm. For larger stones or complex cases, prophylactic ureteral stents may reduce complications.
Area of Science:
- Urology
- Nephrology
- Endourology
Background:
- Ureteral stent use has increased with outpatient extracorporeal shock wave lithotripsy.
- Judicious use of prophylactic stent placement is crucial for maximizing success and minimizing morbidity.
Purpose of the Study:
- To evaluate the efficacy and necessity of prophylactic ureteral stenting in extracorporeal shock wave lithotripsy for kidney stone treatment.
Main Methods:
- Review of controlled retrospective studies and randomized trials comparing outcomes with and without ureteral stenting.
- Analysis of complication rates and stone-free rates based on stone size and type.
Main Results:
- Ureteral stenting does not improve stone-free or complication rates for stones < 2 cm.
- Stenting in smaller stones increases morbidity (urgency, frequency, migration, encrustation).
- Prophylactic stenting may benefit patients with stones > 2 cm, C4 staghorn calculi, or solitary kidneys.
Conclusions:
- Selective use of ureteral stents is recommended based on stone size and patient factors.
- Stenting is not routinely indicated for smaller kidney stones.
- Ureteral stents can aid in stone localization and manipulation in specific complex cases.