Ascorbic acid supplementation effectiveness in reducing Double-J ureteric stent encrustations. A multicenter perspective.

Abstract

Background: Double J (DJ) ureteric stent encrustation is a troublesome complication that may impede its removal. The proposed study aims to investigate the effect of ascorbic acid supplementation on reducing DJ stent encrustations and identify potential risk factors.

Methods: A multi-center, non-concurrent cohort study involved patients who had DJ ureteric stents from July 2017 to January 2024. Group I comprised 359 patients who took 500 mg of ascorbic acid supplements three times daily that continued until the time of DJ removal. In contrast, Group II consisted of 483 patients who did not use the supplement. The study groups were compared in terms of patient demographics, stone criteria, double-J stent encrustations, and stent-related adverse events. The KUB grading system for stent encrustations was utilized.

Results: The study enrolled 842 patients with a prevalence of stent encrustations of 20.43%. The mean K, U, and B scores were 2.14, 1.91, and 2.15, respectively, and the mean total K.U.B. score was 6.2 ± 2.91. The study groups were comparable in terms of patient demographics; however, nine patients (2.5%) in group I had stent encrustations, compared to 163 (33.7%) in group II, with a statistically significant difference (p<0.001). Urinary tract infections (UTIs) were more prevalent in group II at 57.8%, compared to 30% in group I (p=0.02). Lack of treatment with ascorbic acid male gender, and longer duration of indwelling stents were significant predictors of stent encrustations (p<0.05).

Conclusions: Our study has demonstrated that ascorbic acid supplementation could reduce the incidence of encrustations on double- J ureteric stents. Lack of ascorbic acid administration, male gender, and prolonged stent indwelling time were significant predictors for stent encrustations.