Abstract
The liberal use of double-J ureteral stents has been encouraged at the Bay Area Renal Stone Center in an effort to prevent complications and avoid hospitalizations and auxiliary procedures following extracorporeal shock wave lithotripsy (ESWL*) utilizing a Dornier HM3 lithotripter. The rationale for the frequent use of double-J stents resulted from several factors. When this outpatient ESWL center opened, ESWL generally was considered an inpatient procedure. The large number (90) of treating urologists initially had limited experience in ESWL. The Stone Center serviced a large geographic area (radius 150 miles) with a significant number of patients requiring substantial travel time following the shock wave procedure.
Seven hundred eighty-three consecutive patients with an adequate three-month follow-up were retrospectively evaluated. Forty-four percent of the patients required double-J stent insertion prior to the ESWL date for a variety of reasons (i.e., colic, obstruction, or urosepsis). Twenty-eight percent of patients had stents inserted immediately prior to the ESWL with an additional 8% requiring ureteral catheters for stone manipulation or for improved visualization of stones.
Of patients with stents, 2.6% required parenteral injections of pain medications post ESWL. The post-ESWL hospitalization rate of patients with stents was only 4.3%, and the post-ESWL auxiliary procedure rate was 1.7%. Retreatment was required in 3.8% of patients.
In this series, and with the outpatient approach to treatment, the liberal use of double-J ureteral stents appears to have been justified. The disadvantages of stents and future considerations of their prior use also are discussed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Chaussy CG and Schmiedt E: Shock wave treatment for stones in the upper urinary tract. Urol Clin NAm 10: 743, 1983.
Lingeman JE, Newman DM, Mertz, JHO, et al: Extracorporeal shock wave lithotripsy: the Methodist Hospital of Indiana experience. J Urol 135: 1134, 1986.
Drach GW, Dretler SP, Fair WR, et al: Report of the United States cooperative study of extracorporeal shock wave lithotripsy. J Urol 135: 1127, 1986.
Libby J, Meacham R, Griffith D: The role of silicone ureteral stents in extracorporeal shock wave lithotripsy of large renal calculi. J Urol 139: 15, 1988.
Riehle RA: Selective use of ureteral stents before extracorporeal shock wave lithotripsy. Urol Clin N Am 3: 499, 1988.
Fuchs G, Chaussy C, Riehle RA: Treatment of ureteral stones. In Riehle RA, Newman RC (eds): Principles ofExtracorporeal ShockWave Lithotripsy. New York: Churchill Livingstone, 1987.
Chaussy CG: ESWL: past, present and future. J Endourol 2: 97, 1988.
Manzone DJ and Chion B: Extracorporeal shock wave lithotripsy of stones in the upper, mid, and lower ureter. J Endourol 2: 107, 1988.
Francesca F, Di Girolamo V, et al: Extracorporeal shock wave lithotripsy in solitary kidneys. J Endourol 1: 197, 1987.
Thomas R, Robert J, Sloane B, et al: Effect of extracorporeal shock wave lithotripsy on renal function. J Endourol 2: 141, 1988.
Bregg K and Riehle RA: Morbidity associated with internal ureteral stents after shock wave lithotripsy. J Urol 141: 510, 1989.
Saltzman B: Ureteral stents, indications, variations, and complications. Urol Clin N Am 14: 481, 1988.
Shabsigh R, Gleeson MJ, Griffith DP: The benefits of stenting on a more-or-less routine basis prior to extracorporeal shock wave lithotripsy. Urol Clin N Am 15: 493, 1988.
Miller K and Hautmann R: Treatment of distal ureteral calculi with ESWL: experience with more than 100 consecutive cases. World J Urol 5: 259, 1987.
Rassweiler J, Schmidt A, Bub P, et al: The role of ESWL for ureteric stone. In Coptcoat MJ, Miller RA, Wickham JEA (eds): Lithotripsy II. London: BDI Publishing, 1987.
Lingeman JE, Shirrell WL, Newman DM, et al: Management of upper ureteral calculi with extracorporeal shock wave lithotripsy. J Urol 138: 720, 1987.
Evans R, Wingfield D, et al: Ureteral stone manipulation before extracorporeal shock wave lithotripsy. J Urol 139: 33, 1988.
Whelan JP and Finlayson B: Use of retrograde lavage catheter during ESWL treatments. Urology 33: 31, 1989.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1989 Springer Science+Business Media New York
About this chapter
Cite this chapter
York, W.N. (1989). Is the Liberal Use of Double-J Ureteral Stents Justified for Outpatient Extracorporeal Shock Wave Lithotripsy?. In: Lingeman, J.E., Newman, D.M. (eds) Shock Wave Lithotripsy 2. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-2052-5_61
Download citation
DOI: https://doi.org/10.1007/978-1-4757-2052-5_61
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4757-2054-9
Online ISBN: 978-1-4757-2052-5
eBook Packages: Springer Book Archive