Flexible ureteroscopy lithotripsy combined with metallic ureteral stents for the treatment of patients with upper urinary tract calculi

Li,Tian; Sun,Xiangzhou; Li,Xun; He,Yongzhong

doi:10.3892/etm.2020.9038

Flexible ureteroscopy lithotripsy combined with metallic ureteral stents for the treatment of patients with upper urinary tract calculi

Authors:
- Tian Li
- Xiangzhou Sun
- Xun Li
- Yongzhong He
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Affiliations: Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, P.R. China, Department of Urology, The First Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong 510080, P.R. China
Published online on: July 24, 2020 https://doi.org/10.3892/etm.2020.9038
Pages: 3330-3335

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Abstract

Flexible ureteroscopy lithotripsy (FURS) is the most common treatment for patients with upper urinary tract calculi (diameter, <2 cm). The purpose of this prospective study was to assess the efficacy of FURS combined with metallic ureteral stents (MUS) for the treatment of upper urinary tract calculi. A total of 38 patients with upper urinary tract calculi were recruited in the present study, to compare the efficacy between FURS and FURS combined with MUS (FURS‑MUS). The results demonstrated that FURS‑MUS shortened operative time compared with FURS (35.2±1.2 vs. 57.4±1.7 min, respectively; P<0.01). Data also indicated that the clearance rate in FURS‑MUS and FURS was decreased from 94.5 and 87.8%, respectively (P<0.05). FURS‑MUS treatment decreased the duration of postoperative hospital stay compared with FURS (4.5±0.5 vs. 7.5±1.5 days, respectively; P<0.05). These data demonstrated that FURS‑MUS significantly increased postoperative inflammation score compared with FURS (6.2±0.8 vs. 4.2±1.0, respectively; P<0.05). The complication rate and blood loss exhibited no significant difference between FURS‑MUS and FURS (complication rate, 6.5% vs. 5.9%, respectively; blood loss, 4.2% vs. 4.6%, respectively). FURS‑MUS significantly decreased inflammatory cytokines and risk of sepsis, and improved readmission rate, stone recurrence and progression‑free survival compared with patients treated with FURS. In conclusion, these data suggested that FURS‑MUS may be an efficient, minimally invasive and reproducible operation for patients with upper urinary tract calculi.

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1	Jia B, Wu Z and Gu C: Fragment of pubis through the urinary bladder wall causing urinary bladder calculus. Urol Res. 40:181–183. 2012.PubMed/NCBI View Article : Google Scholar
2	Keller JJ, Chen YK and Lin HC: Association between chronic kidney disease and urinary calculus by stone location: A population-based study. BJU Int. 110:E1074–E1078. 2012.PubMed/NCBI View Article : Google Scholar
3	Celik S, Bozkurt O, Kaya FG, Egriboyun S, Demir O, Secil M and Celebi I: Evaluation of computed tomography findings for success prediction after extracorporeal shock wave lithotripsy for urinary tract stone disease. Int Urol Nephrol. 47:69–73. 2015.PubMed/NCBI View Article : Google Scholar
4	Nakasato T, Morita J and Ogawa Y: Evaluation of Hounsfield Units as a predictive factor for the outcome of extracorporeal shock wave lithotripsy and stone composition. Urolithiasis. 43:69–75. 2015.PubMed/NCBI View Article : Google Scholar
5	Pereira-Arias JG, Gamarra-Quintanilla M, Urdaneta-Salegui LF, Mora-Christian JA, Sánchez-Vazquez A, Astobieta-Odriozola A and Ibarluzea-González G: Current status of extracorporeal shock wave lithotripsy in urinary lithiasis. Arch Esp Urol. 70:263–287. 2017.PubMed/NCBI(In Spanish).
6	Guo HQ, Li XG, Gan WD, Zeng LQ, Zhang ZW, Sun XZ and Sun ZY: Clinical investigation of the treatment of children urethral calculi with pneumatic lithotripsy under ureteroscopy. Zhonghua Nan Ke Xue. 9:578–579. 2003.PubMed/NCBI(In Chinese).
7	Keshvari Shirvan M, Darabi Mahboub MR, Rahimi HR and Seyedi A: The evaluation of ureteroscopy and pneumatic lithotripsy results in pregnant women with urethral calculi. Nephrourol Mon. 5:874–878. 2013.PubMed/NCBI View Article : Google Scholar
8	Morcillo E, Fernández I, Pamplona M, Sánchez-Margallo FM and Soria F: Metallic ureteral stents. Present and future. Arch Esp Urol. 69:583–594. 2016.PubMed/NCBI(In Spanish).
9	Chow PM, Hsu JS, Wang SM, Yu HJ, Pu YS and Liu KL: Metallic ureteral stents in malignant ureteral obstruction: short-term results and radiological features predicting stent failure in patients with non-urological malignancies. World J Urol. 32(3):729–736. 2014.PubMed/NCBI View Article : Google Scholar
10	Soria F, Sun F, Duran E, Sánchez FM and Usón J: Metallic ureteral stents versus endoureterotomy as a therapeutic approach for experimental ureteral stricture. J Vasc Interv Radiol. 16:521–529. 2005.PubMed/NCBI View Article : Google Scholar
11	Aboutaleb H: Fluoroscopy free flexible ureteroscopy with holmium: Yttrium-aluminium-garnet laser lithotripsy for removal of renal calculi. Arab J Urol. 14:123–130. 2016.PubMed/NCBI View Article : Google Scholar
12	Chow PM, Chiang IN, Chen CY, Huang KH, Hsu JS, Wang SM, Lee YJ, Yu HJ, Pu YS and Huang CY: Malignant ureteral obstruction: Functional duration of metallic versus polymeric ureteral stents. PLoS One. 10(e0135566)2015.PubMed/NCBI View Article : Google Scholar
13	Abdelhamid M, Mosharafa AA, Ibrahim H, Selim HM, Hamed M, Elghoneimy MN, Salem HK, Abdelazim MS and Badawy H: A prospective evaluation of high-resolution CT parameters in predicting extracorporeal shockwave lithotripsy success for upper urinary tract calculi. J Endourol. 30:1227–1232. 2016.PubMed/NCBI View Article : Google Scholar
14	Davis WR, Halls JE, Offiah AC, Pilkington C, Owens CM and Rosendahl K: Assessment of active inflammation in juvenile dermatomyositis: A novel magnetic resonance imaging-based scoring system. Rheumatology (Oxford). 50:2237–2244. 2011.PubMed/NCBI View Article : Google Scholar
15	Pounis G, Bonaccio M, Di Castelnuovo A, Costanzo S, de Curtis A, Persichillo M, Sieri S, Donati MB, Cerletti C, de Gaetano G and Iacoviello L: Polyphenol intake is associated with low-grade inflammation, using a novel data analysis from the Moli-sani study. Thromb Haemost. 115:344–352. 2016.PubMed/NCBI View Article : Google Scholar
16	Karakose A, Atesci YZ and Aydogdu O: The stone formation in the Memotherm urethral stent implantation area: Is it a rare complication? Can Urol Assoc J. 8:E213–E214. 2014.PubMed/NCBI View Article : Google Scholar
17	Howitt SH, Herring M, Malagon I, McCollum CN and Grant SW: Incidence and outcomes of sepsis after cardiac surgery as defined by the Sepsis-3 guidelines. Br J Anaesth. 120:509–516. 2018.PubMed/NCBI View Article : Google Scholar
18	Maghsoudi R, Etemadian M, Kashi AH and Ranjbaran A: The association of stone opacity in plain radiography with percutaneous nephrolithotomy outcomes and complications. Urol J. 13:2899–2902. 2016.PubMed/NCBI
19	Jiang JT, Li WG, Zhu YP, Sun WL, Zhao W, Ruan Y, Zhong C, Wood K, Wei HB, Xia SJ and Sun XW: Comparison of the clinical efficacy and safety of retroperitoneal laparoscopic ureterolithotomy and ureteroscopic holmium laser lithotripsy in the treatment of obstructive upper ureteral calculi with concurrent urinary tract infections. Lasers Med Sci. 31:915–920. 2016.PubMed/NCBI View Article : Google Scholar
20	Andreoni C, Afane J, Olweny E and Clayman RV: Flexible ureteroscopic lithotripsy: First-line therapy for proximal ureteral and renal calculi in the morbidly obese and superobese patient. J Endourol. 15:493–498. 2001.PubMed/NCBI View Article : Google Scholar
21	Tepeler A, Sninsky BC and Nakada SY: Flexible ureteroscopic laser lithotripsy for upper urinary tract stone disease in patients with spinal cord injury. Urolithiasis. 43:501–505. 2015.PubMed/NCBI View Article : Google Scholar
22	Goldsmith ZG, Wang AJ, Bañez LL, Lipkin ME, Ferrandino MN, Preminger GM and Inman BA: Outcomes of metallic stents for malignant ureteral obstruction. J Urol. 188:851–855. 2012.PubMed/NCBI View Article : Google Scholar
23	Li J, Xiao J, Han T, Tian Y, Wang W and Du Y: Flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants. Exp Biol Med (Maywood). 242:153–159. 2017.PubMed/NCBI View Article : Google Scholar
24	Prstojevic JK, Junuzovic D, Hasanbegovic M, Lepara Z and Selimovic M: Characteristics of calculi in the urinary tract. Materia Sociomed. 26:297–302. 2014.PubMed/NCBI View Article : Google Scholar
25	Kim SH, Jung KI, Koh JS, Min KO, Cho SY and Kim HW: Lower urinary tract symptoms in benign prostatic hyperplasia patients: Orchestrated by chronic prostatic inflammation and prostatic calculi? Urol Int. 90:144–149. 2013.PubMed/NCBI View Article : Google Scholar
26	Badia M, Iglesias S, Serviá L, Domingo J, Gormaz P, Vilanova J, Gavilan R and Trujillano J: Mortality predictive factors in patients with urinary sepsis associated to upper urinary tract calculi. Med Intensiva. 39:290–297. 2015.PubMed/NCBI View Article : Google Scholar : (In Spanish).
27	Noe HN: Hypercalciuria and pediatric stone recurrences with and without structural abnormalities. J Urol. 164:1094–1096. 2000.PubMed/NCBI View Article : Google Scholar