Archivos espanoles de urologia · 2016
[Catheterization after ureteroscopy. Always? never? when?].
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
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Schwartzmann I, Gaya J M, Breda A
Аннотация
OBJECTIVE: The development of smaller diameter ureteroscopes, along with the advance in surgical techniques has allowed ureteroscopy to be progressively less traumatic. The considerable morbidity produced by a ureteral stent makes it advisable to question routine placement.
METHODS: We performed a review of the literature searching for systematic reviews, meta-analysis and prospective randomized clinical trials.
RESULTS: Three systematic reviews and meta-analysis along with 14 clinical trials were included in our review. Most of the consulted articles show a higher incidence of irritative urinary symptoms, and hypogastric and flank pain in patients carrying a JJ stent. No differences were observed in postoperative complication rates.
DISCUSSION: Apparently, there is little benefit in ureteral stenting regarding postoperative complications after uncomplicated ureteroscopy, with a few exceptions. The challenge regarding ureteral stenting after ureteroscopy is to identify the cases that will benefit from it. An interesting alternative, that requires further study, is the placement of a ureteral catheter (internal-external) during the first 24 hours after procedure.
CONCLUSIONS: It seems advisable to place a JJ stent in complicated cases or in those considered to have a higher risk of postoperative complications. In the rest of cases it seems that stenting after ureteroscopy involves more problems tan benefits.
METHODS: We performed a review of the literature searching for systematic reviews, meta-analysis and prospective randomized clinical trials.
RESULTS: Three systematic reviews and meta-analysis along with 14 clinical trials were included in our review. Most of the consulted articles show a higher incidence of irritative urinary symptoms, and hypogastric and flank pain in patients carrying a JJ stent. No differences were observed in postoperative complication rates.
DISCUSSION: Apparently, there is little benefit in ureteral stenting regarding postoperative complications after uncomplicated ureteroscopy, with a few exceptions. The challenge regarding ureteral stenting after ureteroscopy is to identify the cases that will benefit from it. An interesting alternative, that requires further study, is the placement of a ureteral catheter (internal-external) during the first 24 hours after procedure.
CONCLUSIONS: It seems advisable to place a JJ stent in complicated cases or in those considered to have a higher risk of postoperative complications. In the rest of cases it seems that stenting after ureteroscopy involves more problems tan benefits.