Publication:

Effect of stenting and non-stenting prior to extra corporeal shock wave lithotripsy of inferior calyceal stones: a comparative study

Background The rational of using ureteral stents can reduce the complications after extra corporeal shock wave lithotripsy (ESWL) and contribute to successful stone passage. However, the insertion of double J stents during ESWL is controversial. This study was aimed to determine whether the stenting prior to ESWL will increase the stone clearance rate in patients with inferior calyceal calculi and also to study the influence of stone size in the stone fragmentation and clearance.

Methods Patients who had lower ureteric calculi of size ranging from 5-20 mm in diameter and treated with ESWL were included. A detailed history, gender, stone side, stone size, features like dysuria, pyuria, frequency and urgency were taken and compared to that of non-stented group of patients.

Results Total 52 patients (36 males and 16 females) were included in the randomized prospective study. Gender, stone side and stone nature had no significant influence on clearance (p >0.05). Features like dysuria, pyuria, frequency and urgency showed significant correlation with stented patients. Of 52 patients, 27 had stone size more than 1 cm and 25 had stone size less than 1cm. A statistically significant percentage of stone clearance (80%) was found among stented patients with stone size more than 1cm.

Conclusions Stenting prior to ESWL significantly increases the stone clearance rate in patients with inferior calyceal calculi of size >1cm. Parameters like gender side or stone nature had no influence in clearance following ESWL. Frequency, urgency, dysuria and pyuria were significantly more in stented patients.