Preoperative Passive Ureteral Dilatation Using J Stent in Patients with Ureteric Stone (Benefits and Drawbacks)

Abstract

More than 95% 0f ureteric stone are now managed by ureteroscopy or extracorporeal shockwave lithotripsy. Although preoperative double J stent insertion is frequently used, little is known about its indications and results.During the period from November 2013 to October 2014, 38 patients with mid and lower ureteric stone were included in our study. All patients underwent ureteroscopy and laser lithotripsy using semi rigid 9 French ureteroscopy and holmium YAG LASER. The patients divided in to 2 groups the first group (1)includes 18 patients who underwent single session ureteroscopy this group compared to group (2) which included 20 patients who underwent 2 sessions procedure (ureteroscopy 2 to 4 week after ipsilateral double J stent insertion).The tow group compared with regard to operative time, stone free rate, stone migration and ureteric injury. The operative time was significantly shorter in group 2 (p value 0.001), ureteric mucosal injury was lower in group 2 (p value <0.05), while stone migration was higher in group 2 (p value <0.05), other results were comparable between both group.The study concludes that preoperative passive ureteral dilatation has many benefits and drawbacks and is recommended in cases of: any difficulty in accessing the ureter; patients cannot tolerate long operative time and patients with single kidney to avoid ureteral trauma and possible stricture.