The effect of short-term preoperative ureteral stenting on the outcomes of retrograde intrarenal surgery for renal stones.

OBJECTIVES: To evaluate the effect of preoperative ureteral stenting duration on the outcomes of retrograde intrarenal surgery (RIRS).

PATIENTS AND METHODS: We reviewed our database of patients who underwent RIRS between May 2011 and April 2017 at our institution. The patients were divided into three groups according to preoperative ureteral stenting duration: group 1: no stenting, group 2: short preoperative stenting (< 7 days) and group 3: long preoperative stenting (≥ 7 days). We compared the rate of ureteral injury, other perioperative complications, ureteral dilation and readmission, stone-free rate (SFR) and operative time among the groups.

RESULTS: A total of 560 patients (215 in group 1, 177 in group 2 and 168 in group 3) were included in this study. The mean of maximum stone size was 13.1 (± 6.2) mm, the mean number of stones was 2.3 (± 1.9) and preoperative ureteral stenting duration was 7.2 (± 3.7) days. There were no significant differences in operative time (75.6, 78.5 and 82.4 min, p = 0.280), SFR (79.1, 84.2 and 81.0%, p = 0.433), ureteral injury rate (7.0, 5.1 and 2.4%, p = 0.123) and other perioperative complication rates (12.1, 6.8 and 6.0%, p = 0.061). The only one case of grade IV ureteral injury occurred in group 1 and the rate of ureteral dilation was significantly higher than in group 2 and 3 (14.9, 5.7 and 6.0%, p < 0.001).

CONCLUSION: Although preoperative ureteral stenting duration has no significant effect on operative outcomes, it is an effective procedure for reducing the rate of intraoperative ureteral balloon dilation and preventing high-grade ureteral injuries.