An-Najah Staff

Purpose: To prospectively define the role of double J-stent placement following ureteroscopic stone therapy in offering a loin pain free postoperative period for patients with sustain loin pain and documented hydronephrosis.
Material and Methods: Twenty seven patients. mean age 38.59 years (age range 22-60). underwent ureteroscopic therapy for urereral stones. All patients complained of loin pain which did not respond to appropriate medical therapy with various degrees of hydronephrosis documented by ultrasound and/or excretory urogram. The patients were randomized into two groups. 18 patients were stented and 9 patients did not receive a stent following semi-rigid ureteroscopy (7.5/12 Fr) for the treatment of ureteral calculi (pneumatic lithotripsy). The mean stone diameter was 7.7 mm (range 3-13 mm). Intraoperative balloon dilatation of the ureteric orifice was routinely done. All the patients were evaluated during the postoperative 0-6 days in terms of loin pain, hematuria, dysuria. frequency and urgency.
Results: Out of 27 patients, 9 (33.3%) had loin pain in the first few days after the operation andwere in need of intramuscular and/or intravenous analgesics. Four of them were stented (4/18, 22.2%) and five patients did. not have stents (5/9, 55.5%). Lower urinary tract symptoms were not clinically significant and did not affect the quality of life to the extent of loin pain, except in one patient whose stent had migrated into the bladder.
Conclusion: We believe that stenting in patients with documented hydronephrosis accompanied by mucosal edema in sustain renal colic is recommended. Because ureteroscopic therapy may aggregate edema of the ureteric mucosa, double J-stent placement may play an important role in onerinq patients a postoperative period free of loin discomfort. However a further prospective trial should be designed to establish the criteria for stentless ureterorenoscopy