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Patient education is effective in reducing the level of anxiety before and after surgery and increasing the level of readiness for discharge. Patient education provided by nurses can be planned and applied individually. Therefore, this study aims to determine the effect of the education in whom a double J stent after ureteroscopy on their pre- and postoperative anxiety and levels of readiness for discharge. This research study is a randomized controlled trial with control and intervention groups, pre- and posttests. This study was conducted between November 2021 and May 2022 in a university hospital in Turkey. The patients were divided at random into two groups, control (n = 61) and intervention (n = 61). The Personal Information Form, State-Trait Anxiety Inventory (STAI-I, STAI-II), Surgery-Specific Anxiety Scale (SSAS), Readiness for Hospital Discharge Scale for Adult Patients-Short Form (RHDS/SF) and Readiness for Hospital Discharge Scale- Adult-Nurse Assesment Short Form (RN-RHDS/SF) were used to collect the data. The mean SSAS and STAI-I scores on the morning of surgery and before discharge were found to be significantly lower in the intervention group than the control group. The mean RHDS/SF and RN-RHDS/SF scores on the before discharge were found to be significantly higher in the intervention group than the control group. It was concluded that the education provided to the patients in whom a double J stent after ureteroscopy reduced pre- and postoperative anxiety and increased the level of readiness for discharge., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To investigate the safety of short-term stenting following flexible ureteroscopic lithotripsy (fURL) for patients without preoperative stents. Retaining double-J stent for 1-2 weeks after fURL is a common practice. At present, data on short-term stenting after non-pre-stented fURL is still lacking., Methods: 182 patients who met inclusion criteria were retrospectively divided into the 2-days group (2-day removal, 76 cases) and the 1-week group (1-week removal, 106 cases). The study endpoint was stent-associated adverse symptoms assessed by follow-up and completed validated questionnaires on postoperative days (POD) 7 and 12. A postoperative imaging review was performed 1 month after the surgery., Results: No statistical differences were found in the patients' demographic and stone-related characteristics. The 2-days group showed fewer urinary tract symptoms and lower scores on the ureteral stent symptom questionnaire on POD 7: less backache during urination (p = 0.004), less hematuria (p = 0.031), less frequent urination (p = 0.004), lower urinary symptoms index (p < 0.001), lower general health index (p < 0.001), and lower performance index (p < 0.001). There were no significant differences in fever (p = 0.372), visual analogue scale score (p = 0.760), and painkiller requirements (p = 0.160) on POD 7. The average general health score and work performance score remained significantly higher in the 1-week group patients at 5 days after removal compared to the 2-days group patients at 5 days after removal. (p < 0.001, p = 0.005). Five patients in the 2-days group and 15 patients in the 1-week group returned to the emergency department for additional treatments. No patient required rehospitalization. Stone-free rates were 85.5% in the 2-days group and 80.2% in the 1-week group (p = 0.499), respectively, and none of the patients got aggravating hydronephrosis., Conclusions: Compared to the common 1-week stent removal option, short-term stenting after non-pre-stented fURL is safe, which can enhance the patient's quality of life., (© 2024. The Author(s).)

Objectives: To determine whether in pre-stented patients undergoing ureteroscopic stone removal (ureteroscopy retrograde surgery) a tubeless procedure provides a better outcome compared with short-term (6 h) ureteral stenting using an external ureteral catheter., Methods: In this single academic center study (Fast Track Stent study 2), carried out between May 2016 and April 2018, 121 patients with renal or ureteral calculi were initially treated with double-J insertion. Before secondary ureteroscopy retrograde surgery, patients were prospectively randomized into two groups: tubeless versus ureteral catheter insertion for 6 h after ureteroscopy retrograde surgery. Exclusion criteria were acute urinary tract infection, solitary kidney or stone diameter >25 mm. Study end-points were stent-related symptoms assessed by a validated questionnaire (ureteral stent symptom questionnaire), administered both before and 4 weeks after surgery. Numerical ureteral stent symptom questionnaire scores were compared using the Mann-Whitney-U-test. The level of significance was defined as P < 0.05., Results: Ureteroscopy retrograde surgery procedures carried out by 13 surgeons resulted in >90% stone removal in all patients (n = 121), with a mean operation time of 19.9 versus 18.0 min for ureteral catheter versus tubeless, respectively (P = 0.37). Patient groups did not differ significantly in their ureteral stent symptom questionnaire scores (urinary index P = 0.24; pain index P = 0.35). Patients showed a significant preference for tubeless procedure over ureteral catheter reinsertion (Question GQ P < 0.0001). The reintervention rate was 13.3% for the tubeless procedure (n = 8) and 1.6% for the ureteral catheter group (n = 1), respectively (P = 0.034)., Conclusions: Short-term ureteral catheter and no stent insertion after ureteroscopy retrograde surgery stone extraction in pre-stented patients result in comparable quality of life. However, the reintervention rate is higher for tubeless procedures., (© 2020 The Authors. International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Urological Association.)

To evaluate the efficiency and safety of preoperative double-J stent placement for patients undergoing ureteroscopic lithotripsy. Eligible studies were identified from electronic databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews). All analyses were performed by the Review Manager 5.3 (The Cochrane Collaboration, Oxford, UK). Stone-free rate (SFR) was regarded as primary outcome. Second outcomes, including operation time, complication rates as well as major complication rates were also assessed. A total of 11,239 patients (2605 with and 8634 without preoperative stent) from nine retrospective studies were included. Our pooled analysis showed that SFR was significantly higher in patients with a preoperative stent than those without a stent (OR 1.60, 95% CI 1.19-2.15, p = 0.002). Operation time was not significantly different between stented and non-stented groups (OR - 0.89, 95% CI - 5.79-4.01, p = 0.72). No significant differences of complication rates were observed between stented and non-stented groups (OR 0.94, 95% CI 0.67-1.33, p = 0.73). Furthermore, major complication rates were not significantly different between two groups, either (OR 1.07, 95% CI 0.43-2.70, p = 0.88). Generally, preoperative double-J stent placement significantly improved SFR of patients undergoing ureteroscopic lithotripsy. Operation time, complication rates, as well as major complication rates, were similar between stented and non-stented groups. However, the effect of preoperative double-J stent placement for different locations and burden of stones is unclear, more high-quality studies should be anticipated.

Introduction: Ureteral stenting is a common procedure in urology. The cystoscopic removal of Double-J stents (DJ) causes unpleasant side effects with a negative impact on patient's quality of life. The aim of our study was to evaluate this newly developed magnetic DJ and compare it with a standard DJ regarding quality of life with indwelling DJs as well as discomfort during the removal., Material and Methods: The magnetic DJ (Blackstar, Urotech [Achenmühle, Germany]) is a standard 7F ureteral stent with a small magnetic cube fixed through a string on the loop of the distal part of the stent. For DJ removal, a special catheter-like retrieval instrument with a magnetic tip is inserted, the two magnets connect and the retrieval instrument is removed with the DJ. We first tested this DJ in 20 cases. Afterward we evaluated 40 consecutive cases that required a DJ placement after ureterorenoscopy in a prospective randomized manner. The quality of life was assessed by the ureteral stent symptom questionnaire. A visual analogue scale was used to document the pain by DJ removal., Results: There was a significant difference regarding the pain location with the indwelling DJ (p = 0.038). The maximum pain was located in the lower abdomen and/or around the bladder (48%) with the magnetic DJ, whereas the standard DJ caused flank pain in 54% of the patients. The mean time for the magnetic DJ removal including preparation and cleaning as for a transurethral catheter insertion was 9.55 [7-14] minutes, whereas the mean time for the cystoscopic DJ removal was 21.35 [18-30] minutes. The pain caused by the removal of the magnetic DJ was significantly less than that caused by the cystoscopic DJ removal (p = 0.019)., Conclusion: The discomfort caused by the indwelling magnetic DJ is comparable with that caused by the standard DJ. However, the magnetic DJ removal is less painful and faster.

Ureterorenoscopy and double‑J stents are frequently associated with complicated urinary tract infections (cUTI's). To date, it remains unclear whether longer indwelling stent duration increases the risk of cUTI's and recommendations on this subject are therefore lacking. This study investigates whether double‑J stent placement and longer indwelling stent duration prior to URS increase the risk of post-URS cUTI's. Adult patients undergoing ureterorenoscopy in 2019 were eligible for study participation. Records were retrospectively collected. Potential risk factors were evaluated using multivariate logistic regression models. 16.9% of the prestented patients was diagnosed with a UTI, compared to 7.1% in the non-prestented group (p = 0.034). Female gender, preoperative positive urine cultures and stone recurrence were significant risk factors. This study demonstrated a correlation between preoperative placement of double‑J stents and post-URS complicated UTI's. However, neither preoperative double‑J stent placement nor longer indwelling stent time was a significant risk factor for postoperative complicated UTI's. [ABSTRACT FROM AUTHOR]

Abstract Objectives To investigate the outcomes of internal ureteral stents in comparison with ureteroscopy (URS) for pregnant women with urolithiasis. Data sources Relevant studies published from January 1980 to June 2022 were identified through systematic literature searches of MEDLINE, EMBASE, Web of Science and the Cochrane Library. Methods of study selection A total of 499 studies were initially identified. We included pregnant women in any stages of gestation who underwent double-J (D-J) stent insertion only or ureteroscopy for the treatment of urolithiasis; for a study to be included, the number of participants needed to exceed 10. This systematic review was registered on the PROSPERO website (Reference: CRD42020195607). Results A total of 25 studies were identified with 131 cases undergoing serial stenting and 789 cases undergoing URS. The pooled operative success rate was 97% for D-J stent insertion and 99% for URS. Only a few patients passed stones spontaneously after serial D-J stenting. The pooled stone free rate (SFR) in URS operations was about 91%. For internal ureteral stent therapy, the rate of normal fertility outcomes was 99%, although the pooled incidence of complications was approximately 45%. For group receiving URS treatment, the rate of normal fertility outcome was 99% and the pooled incidence of complications was approximately 1%. However, the pooled rate of premature birth and abortion were the similar between the two groups (

Introduction: The aim of our study was to retrospectively evaluate the stone-free rate after the second intervention for every performed procedure (semirigid ureteroscopy, flexible ureteroscopy, semirigid plus flexible ureteroscopy and percutaneous nephrolithotomy). Materials and methods: A total of 149 patients, who came to the emergency room of "Saint John" Emergency Clinical Hospital, Bucharest, Romania, with acute renal pathology suggesting the presence of renal and/or ureteral lithiasis confirmed by imagining (x-ray, ultrasonography or computer tomography), were included in this retrospective study, which was conducted between September 2021 and September 2022. All selected patients had an indication of emergency surgical intervention that consisted of a double-J stent mounting. We analyzed the stone-free rate after the secondary intervention, which was one of the following procedures: semirigid ureteroscopy, flexible ureteroscopy, combined semirigid and flexible ureteroscopy (F-URS), and percutaneous nephrolithotomy (PCNL). Patients came back for the secondary intervention and were reevaluated using imaging techniques. Results: Endoscopic procedures were performed by 14 surgeons over a time period of two to six weeks after the initial stenting procedure. Encrusted stents were encountered in four cases and in five cases the patients were admitted with obstruction of previously inserted stents. From the total of 149 patients, 68 (45,6%) subjects underwent semirigid ureteroscopy, with a stone-free rate of 86% (59 cases), 32 (21,4%) F-URS, with a stone-free rate of 90,6% (30 cases), 41 (27,5%) combined flexible and semirigid ureteroscopy, with a stone-free rate of 90,24% (37 cases), and eight (5,3%) patients received PCNL, with a stone-free rate of 75% (six cases). Overall stone-free rate for all procedures was 90,06%. The mean operative time was 23 minutes. No major incidents or complications occurred during the procedures. Conclusion: The emergency pre-stenting before the definitive treatment of reno-ureteral lithiasis is a safe procedure. Flexible ureteroscopy was the most successful secondary intervention, with the highest rate of achieving stone-free status. [ABSTRACT FROM AUTHOR]

Abstract Background Endourological procedures are widely used to treat benign urinary disorders and the double-J stent is routinely used. However, its potential impact on sexual function remains unclear. Therefore, we performed a quantitative systematic review to determine the relationship between endourological procedures with or without double-J stent and post-operative sexual function. Methods We conducted a search of PubMed, EMBASE, Web of Science, and Cochrane Library databases up to December 2018 for studies that compared sexual function before and after endourological procedures. The quality of the included studies was evaluated using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I). We performed subgroup analyses to explore heterogeneity. A random effects model was used to combine the results. Results Five prospective studies involving 485 sexually active participants were identified. Pooled results showed that, in patients without a double-J stent, the change in sexual function after endourological procedures was not significant in men (mean difference [MD]: − 0.61, 95% confidence interval [CI]: − 1.43 to 0.22, p = 0.148) or women (MD: 0.53, 95% CI: − 0.52 to 1.57, p = 0.322). However, in patients with indwelling double-J stent, sexual function scores significantly declined after the procedure in both men (MD: -4.25, 95% CI: − 6.20 to − 2.30, p

Objective: Ureterorenoscopic stone surgery (USS) is the primary method of ureteral stone treatment. Double-J (JJ) stenting is an integral part of a USS, and most urologists prefer to use it without an extraction string. The probable reason for such preference could be the lack of reliable and sufficient data on JJ stent use with an extraction string. Materials and Methods: A total of 177 patients who underwent USS were divided into four groups: Group 1 men (JJ stent was manually removed), group 2 men (JJ stent was cystoscopically removed), group 3 women (JJ stent was manually removed), and group 4 women (JJ stent was cystoscopically removed). We investigated the impact of two different JJ stent removal techniques on pain perception, lower urinary tract symptoms (LUTS), depressive symptomatology, complications, and cost. Results: Compared to groups 1 and 3, the mean surgery times were higher in groups 2 and 4 (p=0.001). Preoperative LUTS scores were similar in all groups (p>0.05). Postoperative pain scores in groups 3 and 4 were similar (p=0.06), but they were lower in group 1 than in group 2 (p=0.004). Postoperative Beck depression inventory scores were lower in groups 1 and 3 (p<0.02). The total cost of USS was 28.5% higher in groups 2 and 4 compared to groups 1 and 3. Conclusion: It is concluded that JJ stent removal with an extraction string is a reliable method with low treatment costs that does not adversely affect surgical outcomes. [ABSTRACT FROM AUTHOR]

Background: Endourological procedures are widely used to treat benign urinary disorders and the double-J stent is routinely used. However, its potential impact on sexual function remains unclear. Therefore, we performed a quantitative systematic review to determine the relationship between endourological procedures with or without double-J stent and post-operative sexual function.Methods: We conducted a search of PubMed, EMBASE, Web of Science, and Cochrane Library databases up to December 2018 for studies that compared sexual function before and after endourological procedures. The quality of the included studies was evaluated using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I). We performed subgroup analyses to explore heterogeneity. A random effects model was used to combine the results.Results: Five prospective studies involving 485 sexually active participants were identified. Pooled results showed that, in patients without a double-J stent, the change in sexual function after endourological procedures was not significant in men (mean difference [MD]: - 0.61, 95% confidence interval [CI]: - 1.43 to 0.22, p = 0.148) or women (MD: 0.53, 95% CI: - 0.52 to 1.57, p = 0.322). However, in patients with indwelling double-J stent, sexual function scores significantly declined after the procedure in both men (MD: -4.25, 95% CI: - 6.20 to - 2.30, p < 0.001) and women (MD: -7.17, 95% CI: - 7.88 to - 6.47, p < 0.001).Conclusions: Our meta-analysis suggests that indwelling double-J stent after endourological procedures could be a crucial factor causing temporary sexual dysfunction post-operatively. Our results may be used to provide evidence-based advice to patients. [ABSTRACT FROM AUTHOR]

Ureteral catheters are frequently used in urology clinics for intrinsic or extrinsic pathologies which cause ureteral obstruction to provide urinary drainage from the kidney to the bladder. With the increase in stent use, an increase is observed in complications occurring due to ureteral stents in direct proportion with this increase, and ureteral double‑J (DJ) stents forgotten in the urinary system are observed commonly in urological cases when the patients do not refer to a health institution in this condition and may cause severe problems, such as infection, stent fragmentation, migration, kidney failure, encrustation, and hydronephrosis conditions. A 30‑year‑old male patient referred to our clinic with right‑side pain, dysuria, and incontinence complaints. It was learned that the patient had endoscopic stone surgery due to right ureteral stone and kidney stone 11 years before the presentation. In the imaging methods of the patient, it was observed that the DJ stent forgotten had separated into three parts, and stones were observed in the right ureter. Cystoscopy was made under general anesthesia. The torn distal end of DJ stent was observed in distal urethra. The foreign object was removed with forceps. Then with ureterorenoscope, the stones integrated with the stent at the end of the piece of DJ stent in the ureter were fragmented with pneumolithotriptor. Stone pieces and the second removed part of the stent were extracted with foreign object forceps. Then using nephroscope through percutaneous intervention, the stones at the end of the third torn piece of DJ stent were fragmented with pneumolithotriptor. They were extracted with forceps. After DJ stent installation, each patient should be checked by giving required information and told that the stent must be removed. In cases with forgotten stents and complications, the stents should be removed with suitable medical, endourological, or minimally invasive surgical methods taking care to protect kidney functions. [ABSTRACT FROM AUTHOR]

Objectives: We conducted this study to evaluate patients with retained encrusted ureteral stents, identify the predisposing factors and present our experience in the management of such challenging problem. Materials and Methods: This prospective study was carried out in the period from May 2007 to February 2011 at the Urology and Nephrology Center, Al-Thawra General Hospital, Sana’a, Yemen. 40 patients with retained encrusted ureteric stents were treated at our center. All patients were initially evaluated with a radiographic imaging for assessment of stent encrustation and stone burden. Treatment decisions were based on the site and severity of encrustations in the renal pelvis, ureter and bladder and on our technical situation and availability of instrumentations. Multi-modal approaches ranging from extra-corporeal shock wave lithotripsy (ESWL) to endourological and open urologic procedures were used to achieve stent removal. Results: A total of 90 urological procedures were performed to render all 40 patients stent and stone free. The average duration of stent remained indwelling was 24.2 months (range 4 months -16 years). All patients were managed either by minimally or more invasive multi-modal endourological approaches. For upper coil encrustation percutaneous nephrolithotripsy was performed in eight patients, pyelolithotomy in two patients and ESWL in three patients. Encrustation of the body was treated initially by ESWL, followed by retrograde ureteroscopic manipulation in 12 patients. Lower coil encrustation was successfully managed by cystolitholapaxy in seven patients and one patient required cystolithotomy. Cystolithotomy, pyelolithotomy and ureterolithotomy were carried out in two patients. Two patients who had large burden bladder and kidney stones with loss of kidney function underwent nephrectomy and cystolithotomy. Conclusions: The retrieval of severely encrusted retained ureteral stent and its associated stone burden poses a real management challenge for urologists due to the need for multimodal procedures and the lack of standardized treatment plan. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the morbidity, complication rate, and pain perception during removal of a novel ureteric stent with a magnetic end using a-traumatic retrieval catheter. Methods: Between November 2013 and July 2015, 151 consecutive patients who underwent semirigid ureterorenoscopy (URS) for stone removal were prospectively enrolled. Stent removal was performed under local anesthesia using a special magnetic-end stent remover 1 week following URS. At follow-up, we obtained patients' medical history, urine culture result, renal ultrasonogram, and visual analog scale (VAS) score regarding stent irritation (VAS 1) and pain during removal (VAS 2). Results: Pain perception during stent removal was significantly less painful in patients with a magnet stent than in those with a regular stent (p < 0.001). Stent irritation was slightly higher in patients with an indwelling magnet stent than in those with a regular stent (p < 0.001). No significant differences in stent irritations were found in patients who had a magnetic stent for 4 weeks after laparoscopic pyeloplasty (p = 0.20). Patients with a magnetic stent experienced significantly less pain during removal with a median VAS 2 score of 2.5 and a mean VAS 2 score of 2.58 [standard deviation (SD) ± 0.90] than those without a magnetic stent a median VAS 2 of 6 and a mean VAS 2 of 5.88 (SD ± 1.43). The stent length correlated with stent irritation (p = 0.05), and it significantly correlated with pain during removal (p < 0.001). Conclusion: The magnetic-end ureteric double-J stent is a safe option associated with less pain, particularly for male patients requiring short-term ureteric stenting. [ABSTRACT FROM AUTHOR]

Purpose: To propose and evaluate a new endoscopic technique using only a retrograde ureteroscopic approach for the removal of heavily encrusted ureteral stents. Methods: Data from 51 consecutive patients with encrusted and retained ureteral stents were prospectively collected. Description of the successive steps of surgery is detailed. The holmium yttrium aluminum garnet (Ho:YAG) laser properties offer the opportunity for fragmentation of stent-attached encrustation and the ability to cut the stent itself. Reducing the length of the stent is critical to creating space in the ureter and to allow free access for ureteroscopes or ureteral access sheath placement. The primary outcome of this study was the feasibility and the safety of this retrograde intrarenal approach. Some factors of encrustation and outcomes are also discussed in comparison with lithotripsy, percutaneous, laparoscopic, open surgery, or a combination of these techniques. Results: The removal of the encrusted stent was possible with only this retrograde technique in 98% of patients. The transection of the encrusted stent with the Ho:YAG laser was useful in 71% of the patients. Mean operative time was 110 minutes and mean hospital stay was 2.33 days. Postoperative complications were mainly nonobstructive pyelonephritis (10%). The most significant predictor of this life-threatening complication was the presence of struvite stones with the encrusted stent ( p = 0.018). Contrariwise, operative time, body mass index, gender, and encrustation rate were not associated with postoperative pyelonephritis. Both cystine stone disease and pregnancy led to faster stent encrustation. Conclusions: Retrograde ureteroscopic surgery is efficient and safe for removing retained stents and associated stone burdens. The Ho:YAG laser is essential to perform the encrustation removal and sectioning of the stent. [ABSTRACT FROM AUTHOR]

Double-j (DJ) ureteral stenting is a very common procedure performed after various endourological procedures. Although several complications due to DJ stent insertion were revealed, only three cases of renal parenchymal perforation have been reported to date. We present a case of a 35- year-old woman who had perforation of renal parenchyma without perirenal hematoma following insertion of DJ ureteral stent after flexible ureteroscopy (FURS) for the treatment of an upper ureteral calculi. Non-contrast computed tomography (CT) was used for diagnosis. Patient was successfully managed with repositioning of the stent under fluoroscopic guidance on postoperative second day postoperatively. [ABSTRACT FROM AUTHOR]