Optimum duration of ureteral prestenting dwelling time in children undergoing retrograde intrarenal surgery

      Summary

      Introduction and objectives

      Ureteral prestenting before retrograde intrarenal surgery (RIRS) causes passive dilatation of the ureter, improves stone-free rate and is associated with shorter operative time. However, the presence of a ureteric stent may increase the risk for septic complications, which accelerates with increased dwelling time duration. The aim of the present study is to explore the impact of ureteral prestenting timing in a group of children undergoing retrograde intrarenal surgery (RIRS) on perioperative outcomes and complication rates and to define the optimum duration of prestenting dwelling time.

      Patients and methods

      A retrospective study on 60 children aged less than 14 years, presented with upper tract urinary stones, who were subdivided into two groups: Group 1 and 2, each included 30 children who had undergone RIRS after ureteric stenting for two weeks and four weeks respectively. Success of ureteroscope introduction, operative time, stone free rate (SFR), intraoperative and postoperative complications and number of retreatment procedures after definitive RIRS were recorded and compared between the two treatment groups.

      Results

      Ureteric access was successfully obtained in all children in both groups. Patients in group 1 and 2 had a SFR of 86.6% and 90%, respectively (p = 0.199). The mean operative time of group 1 and 2 were 56.5 and 52.9 min (p = 0.612). Postoperative UTI rates increased with prolonged dwelling time from 6.7% in group 1 to 30% in group 2. No patient in both groups developed high grade complications.

      Conclusions

      Figure 1
      Graphical AbstractFlow charts of children enrolled in the study.

      Keywords

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