The role of preoperative ureteral stenting in retrograde intrarenal surgery outcomes for renal stones: a matched-pair analysis.

Abstract

Introduction: Ureteral stenting is not routinely recommended, but it may be performed before or after retrograde intrarenal surgery (RIRS). We aimed to investigate the effect of preoperative ureteral stenting on the success rate and intraoperative, postoperative, and infectious complications in RIRS.

Material and methods: We retrospectively analysed the data of 581 patients who underwent RIRS. Demographic data, stone characteristics, presence of hydronephrosis, presence of congenital kidney anomaly and solitary kidney, duration of operation, and duration of hospitalisation were analysed. Intraoperative, postoperative, and infectious complications and the success rate of all operations were recorded. The patients were divided into 2 groups as prestented and non-prestented and matched in terms of age, sex, stone size, and number of stones. Ninety-four patients in the prestented group were matched with 282 patients in the non-prestented group with respect to age, sex, stone size, and number of stones (matched 1:3).

Results: The 2 groups were similar in terms of matching parameters and all other characteristics. After matching, the success rate was 77.7% (73/94) in the prestented group and 78% (220/282) in the non--prestented group, and there was no statistically significant difference between the 2 groups (p = 0.943). The intraoperative complication rate was statistically significantly higher in the non-prestented group (19.2% vs 28.7%, p = 0.046). Postoperative complications occurred in 22.3% of patients in the prestented group and 20.7% of patients in the non-prestented group (p = 0.429).

Conclusions: Preoperative ureteral stenting in RIRS was not associated with the success rate or postoperative and infectious complications. However, preoperative stenting was effective in decreasing only grade 1 intraoperative complications.