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Üreteral stent çapının rijit üreterolitotripsi sonrası yaşam kalitesi ve operasyon sonrası komplikasyonlar üzerine klinik etkisi

Year 2022, Volume: 14 Issue: 1, 22 - 27, 31.01.2022
https://doi.org/10.54233/endouroloji.1059177

Abstract

Amaç: Üreterolitotripsi sonrası takılan üreteral Double-j (Dj) stentlerin hasta konforuna olumsuz etkileri sıklıkla karşımıza çıkmaktadır. Çalışmamızda daha küçük çapta (4 Fr) Dj stent takılan hastalarla, rutinde en sık kullanılan 4,7 Fr Dj stent takılan hastaların operasyon sonrası yaşam kalitelerini ve komplikasyon oranlarını karşılaştırmayı amaçladık.
Gereç ve Yöntemler: Ocak 2021- Aralık 2021 arasında iki merkezde üreterolitotripsi yapılıp dahil etme kriterlerine uygun olan hastalar 4 Fr ve 4,7 Fr Dj stent takılanlar olarak iki gruba ayrıldı. Taşları tamamen fragmante edilen, geride kalan taşı olmayan, taş boyutu 10 mm ve daha küçük olan hastalar çalışmaya dahil edildi. Veriler hastane otomasyon sistemi ve eş zamanlı tutulan hasta dosyalarından elde edildi. Hastalar operasyon sonrası birinci haftada kısa form-12 (SF-12: short form-12) ölçeğiyle fiziksel ve mental bileşenleri ayrı ayrı değerlendirildi. Operasyon sonrası üçüncü haftada Dj stentleri çekilene kadar olan stent intoleransı nedeniyle acil servis başvurusu, ağrı kesici gereksinimi, stent migrasyonu ve operasyon sonrası üriner sistem enfeskiyonu (İYE) gibi komplikasyonlar ayrıca değerlendirildi.
Bulgular: Her bir grupta 30 hasta olmak üzere toplam 60 hasta çalışmaya dahil edildi. 4 Fr Dj stent takılan hastalarda operasyon sonrası birinci haftada kısa form-12 ölçeğinin fiziksel bileşen skoru daha yüksek olarak saptandı (sırası ile, 48,8 vs. 43,9, p= 0,005), benzer olarak mental bileşen skoru da bu grupta daha yüksek olarak görüldü (sırası ile, 53,9 vs. 46,4, p= 0,001). Her iki grupta operasyon sonrası komplikasyonlar açısından istatistiksel anlamlı bir fark saptanmadı.
Sonuç: Her iki stent çeşidi operasyon sonrası benzer komplikasyon oranlarına sahip olsa da üreterolitotripsi sonrası 4 Fr Dj stent, hastaların yaşam kalitesini 4,7 Fr Dj stente göre daha az olumsuz etkilemektedir  

References

  • 1. C. Türk (Chair), A. Neisius, A. Petřík, C. et al. Guidelines on Urolithiasis. EAU Guidel Edn Present EAU Annu Congr Milan 2021 ISBN 978-94-92671-13-4.
  • 2. Nabi G, Cook J, N’Dow J, McClinton S. Outcomes of stenting after uncomplicated ureteroscopy: systematic review and meta-analysis. BMJ [Internet]. 2007 Mar 17;334(7593):572. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.39119.595081.55
  • 3. Bosio A, Alessandria E, Dalmasso E et al. How bothersome double-J ureteral stents are after semirigid and flexible ureteroscopy: a prospective single-institution observational study. World J Urol [Internet]. 2019 Jan 19;37(1):201–7. Available from: http://link.springer.com/10.1007/s00345-018-2376-6
  • 4. Wu G, Sun F, Sun K et al. Impact of differential ureteral stent diameters on clinical outcomes after ureteroscopy intracorporeal lithotripsy: A systematic review and meta‐analysis. Int J Urol [Internet]. 2021 Oct 29;28(10):992–9. Available from: https://onlinelibrary.wiley.com/doi/10.1111/iju.14631
  • 5. Nestler S, Witte B, Schilchegger L, Jones J. Size does matter: ureteral stents with a smaller diameter show advantages regarding urinary symptoms, pain levels and general health. World J Urol [Internet]. 2020 Apr;38(4):1059–63. Available from: http://link.springer.com/10.1007/s00345-019-02829-0
  • 6. Erturk E, Sessions A, Joseph J V. Impact of Ureteral Stent Diameter on Symptoms and Tolerability. J Endourol [Internet]. 2003 Mar;17(2):59–62. Available from: http://www.liebertpub.com/doi/10.1089/08927790360587342
  • 7. Kim BS, Choi JY, Jung W. Does a Ureteral Stent with a Smaller Diameter Reduce Stent-Related Bladder Irritation? A Single-Blind, Randomized, Controlled, Multicenter Study. J Endourol [Internet]. 2020 Mar 1;34(3):368–72. Available from: https://www.liebertpub.com/doi/10.1089/end.2019.0482
  • 8. Cubuk A, Yanaral F, Ozgor F et al. Comparison of 4.8 Fr and 6 Fr ureteral stents on stent related symptoms following ureterorenoscopy: A prospective randomized controlled trial. Kaohsiung J Med Sci [Internet]. 2018 Dec;34(12):695–9. Available from: http://doi.wiley.com/10.1016/j.kjms.2018.07.001
  • 9. Damiano R, Autorino R, De Sio M et al. Does the Size of Ureteral Stent Impact Urinary Symptoms and Quality of Life? A Prospective Randomized Study. Eur Urol [Internet]. 2005 Oct;48(4):673–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0302283805003714

Clinical impact of ureteral stent diameter on the quality of life and complication following ureterolithotripsy

Year 2022, Volume: 14 Issue: 1, 22 - 27, 31.01.2022
https://doi.org/10.54233/endouroloji.1059177

Abstract

Objective: Ureteral double J (Dj) stents placed after ureterolithotripsy often have negative effects on the patient’s comfort. In our study, we aimed to compare the postoperative quality of life (QoL) and postoperative complication rates of the patients with a smaller diameter (4 Fr) Dj stent and the most frequently used 4.7 Fr Dj stent.
Material and Methods: Patients who had ureterolithotripsy at two centers between January 2021 and December 2021 and met the inclusion criteria were divided into two groups as those with 4 Fr and 4.7 Fr Dj stent placement. Patients with complete fragmentation, no residual stones, and a stone size of 10 mm or smaller were included in the study. Data were obtained from the hospital automation system and patient files. The physical and mental components of the patients were evaluated separately with the SF-12 (Short form-12) QoL scale in the first postoperative week. Postoperative complications such as emergency admission due to stent intolerance, analgesic requirement, stent migration, and postoperative urinary system infection (UTI) were also evaluated until Dj stents were removed in the third postoperative week.
Results: A total of 60 patients, 30 patients in each group, were included in the study. The physical component score of the SF-12 scale was higher in the first postoperative week in patients with a 4 Fr DJ stent (48.8 vs. 43.9, p= 0.005, respectively), and similarly, the mental component was higher in this group (53.9 vs. 46.4, p= 0.001, respectively). There was no statistically significant difference in terms of postoperative complications in both groups.
Conclusion: Although both stent types have similar post-operative complication rates, the 4 Fr Dj stent after ureterolithotripsy affects the quality of life of patients less negatively than the 4.7 Fr Dj stent.

References

  • 1. C. Türk (Chair), A. Neisius, A. Petřík, C. et al. Guidelines on Urolithiasis. EAU Guidel Edn Present EAU Annu Congr Milan 2021 ISBN 978-94-92671-13-4.
  • 2. Nabi G, Cook J, N’Dow J, McClinton S. Outcomes of stenting after uncomplicated ureteroscopy: systematic review and meta-analysis. BMJ [Internet]. 2007 Mar 17;334(7593):572. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.39119.595081.55
  • 3. Bosio A, Alessandria E, Dalmasso E et al. How bothersome double-J ureteral stents are after semirigid and flexible ureteroscopy: a prospective single-institution observational study. World J Urol [Internet]. 2019 Jan 19;37(1):201–7. Available from: http://link.springer.com/10.1007/s00345-018-2376-6
  • 4. Wu G, Sun F, Sun K et al. Impact of differential ureteral stent diameters on clinical outcomes after ureteroscopy intracorporeal lithotripsy: A systematic review and meta‐analysis. Int J Urol [Internet]. 2021 Oct 29;28(10):992–9. Available from: https://onlinelibrary.wiley.com/doi/10.1111/iju.14631
  • 5. Nestler S, Witte B, Schilchegger L, Jones J. Size does matter: ureteral stents with a smaller diameter show advantages regarding urinary symptoms, pain levels and general health. World J Urol [Internet]. 2020 Apr;38(4):1059–63. Available from: http://link.springer.com/10.1007/s00345-019-02829-0
  • 6. Erturk E, Sessions A, Joseph J V. Impact of Ureteral Stent Diameter on Symptoms and Tolerability. J Endourol [Internet]. 2003 Mar;17(2):59–62. Available from: http://www.liebertpub.com/doi/10.1089/08927790360587342
  • 7. Kim BS, Choi JY, Jung W. Does a Ureteral Stent with a Smaller Diameter Reduce Stent-Related Bladder Irritation? A Single-Blind, Randomized, Controlled, Multicenter Study. J Endourol [Internet]. 2020 Mar 1;34(3):368–72. Available from: https://www.liebertpub.com/doi/10.1089/end.2019.0482
  • 8. Cubuk A, Yanaral F, Ozgor F et al. Comparison of 4.8 Fr and 6 Fr ureteral stents on stent related symptoms following ureterorenoscopy: A prospective randomized controlled trial. Kaohsiung J Med Sci [Internet]. 2018 Dec;34(12):695–9. Available from: http://doi.wiley.com/10.1016/j.kjms.2018.07.001
  • 9. Damiano R, Autorino R, De Sio M et al. Does the Size of Ureteral Stent Impact Urinary Symptoms and Quality of Life? A Prospective Randomized Study. Eur Urol [Internet]. 2005 Oct;48(4):673–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0302283805003714
There are 9 citations in total.

Details

Primary Language Turkish
Subjects Urology
Journal Section Research Articles
Authors

Hüseyin Özgür Kazan 0000-0003-0202-0454

Muhammet Çiçek 0000-0001-5478-3352

Barış Çalışkan This is me 0000-0001-9213-8901

Ömer Erdoğan This is me 0000-0001-8788-8302

Asıf Yıldırım 0000-0002-3386-971X

Publication Date January 31, 2022
Published in Issue Year 2022 Volume: 14 Issue: 1

Cite

Vancouver Kazan HÖ, Çiçek M, Çalışkan B, Erdoğan Ö, Yıldırım A. Üreteral stent çapının rijit üreterolitotripsi sonrası yaşam kalitesi ve operasyon sonrası komplikasyonlar üzerine klinik etkisi. Endourol Bull. 2022;14(1):22-7.