Huettenbrink C.a· Popeneciu V.a· Ell J.a· Hitzl W.b,c,d· Distler F.A.a

Author affiliations

aDepartment of Urology, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
bResearch and Innovation Management (RIM), Biostatistics and Publication of Clinical Trial Studies Paracelsus Medical University, Salzburg, Austria
cDepartment of Ophthalmology and Optometry, Para Celsus Medical University Salzburg, Salzburg, Austria
dResearch Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Salzburg, Austria

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Access via DeepDyve Unlimited fulltext viewing Of this article Organize, annotate And mark up articles Printing And downloading restrictions apply

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: May 21, 2022
Accepted: September 09, 2022
Published online: October 25, 2022

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 3

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Introduction: Ureter stones leading to severe pain and urosepsis are usually treated by emergency primary ureteral stenting. However, this intervention can significantly change the location of the stone, potentially also changing the preferred method and/or technical aspects of definitive treatment. We analyzed stone location changes and consequences after emergency ureteral stent insertion prior to secondary ureterorenoscopy. Methods: We performed a retrospective analysis of stone locations in 649 patients with a mean age of 52 ± 16 years who were treated with ureterorenoscopy for symptomatic stones from May 2016 to December 2019. All patients with single unilateral ureterolithiasis undergoing definitive stone treatment by secondary ureterorenoscopy were included. In 469 patients, ureteral stone localization before emergency ureteral stenting and at subsequent ureterorenoscopy was evaluated. Additionally, the use of flexible ureterorenoscopy for complete stone removal was also recorded. Results: Inadvertent repositioning of ureteral stones with a mean diameter of 6.9 (±3.1) mm after ureteral stenting was observed in 45.6%. 119 (25.4%) ureteral stones were displaced back into the kidney. Proximal stones showed a particularly high incidence of repositioning into the renal pelvis (42%, p < 0.05). The majority of cases required the use of flexible ureterorenoscopy showed a primary proximal ureteral localization (60 of 85 patients, 70.5%). Discussion/Conclusion: Emergency ureteral stenting for ureterolithiasis may change the location of a stone, potentially affecting therapy planning, particularly in the case of proximal stones. Imaging control prior to definitive stone treatment is thus especially advisable for proximal ureteral stones.

© 2022 S. Karger AG, Basel

References Reicherz A, Sahin R, Häuser L, Noldus J, Bach P. An empirical study on the operative treatment of symptomatic urolithiasis in Germany. Urol Int. 2021;105(3–4):240–6. Türk C, Neisius A, Petřík A, Seitz C, Thomas K, Skolarikos A. EAU Guidelines on urolithiasis 2020. European Association of Urology Guidelines 2020 Edition. The European Association of Urology Guidelines Office; 2020. Eismann L, Kretschmer A, Bader MJ, Kess S, Stief CG, Strittmatter F. Adherence to guidelines in the management of urolithiasis: are there differences among distinct patient care settings? World J Urol. 2021 Aug;39(8):3079–87. Pratsinis M, Tekin AC, Zumstein V, Güsewell S, Schmid HP, Abt D, et al. Urinary stone location with ureteral stents in place: always on the move, and not where you would expect. Urol J. 2020 Nov 18;17(6):667–70. AWMF: S2k-Leitlinie zur Diagnostik, Therapie und Metaphylaxe der Urolithiasis. AWMF Registernummer: 043–025. 2018. https://www.awmf.org/uploads/tx_szleitlinien/043-025L_S2k_Diagnostik_Therapie_Metaphylaxe_Urolithiasis_2019-07_1.pdf. Baumgarten L, Desai A, Shipman S, Eun DD, Pontari MA, Mydlo JH, et al. Spontaneous passage of ureteral stones in patients with indwelling ureteral stents. Can J Urol. 2017 Oct;24(5):9024–9. Kuebker JM, Robles J, Kramer JJ, Miller NL, Herrell SD, Hsi RS. Predictors of spontaneous ureteral stone passage in the presence of an indwelling ureteral stent. Urolithiasis. 2019;47(4):395–400. Traxer O, Thomas A. Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol. 2013 Feb;189(2):580–4. Mckay A, Somani BK, Pietropaolo A, Geraghty R, Whitehurst L, Kyriakides R, et al. Comparison of primary and delayed ureteroscopy for ureteric stones: a prospective non-randomized comparative study. Urol Int. 2021;105(1–2):90–4. Lennon GM, Thornhill JA, Grainger R, McDermott TE, Butler MR. Double pigtail ureteric stent versus percutaneous nephrostomy: effects on stone transit and ureteric motility. Eur Urol. 1997;31(1):24–9. Article / Publication Details

First-Page Preview

Received: May 21, 2022
Accepted: September 09, 2022
Published online: October 25, 2022

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 3

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.