HÜSEYİN ÇELİK, AHMET ÇAMTOSUN, Caner Ediz, İbrahim TOPÇU, RAMAZAN ALTINTAŞ, Cemal TAŞDEMİR

Frequency of Stent Placement after Ureteroscopic Lithotripsy in a University and a State Hospital

Amaç: Çalışmanın amacı, taş hastalığının endemik ol- duğu ve sık üreterorenoskopi yapılan iki farklı şehirdeki üniversite hastanesi ve devlet hastanesinde yapılan üre- terorenoskopik litotripsi sonrası üreteral stent yerleştirme sıklığının karşılaştırılmasıdır. Yöntemler: İki bin on dört Ocak ayı ile 2014 Mayıs ta- rihleri arasında İnönü üniveritesi Turgut Özal Tıp Merkezi Hastanesi (TÖTM) ve Osmaniye Devlet Hastanesi (ODH) üroloji kliniklerine başvuran hastalar retrospektif olarak değerlendirildi. Üreteral taşa bağlı olarak üreteroskopik litotripsi yapılan hastalar taş lokalizasyonu, boyutu, ektazi dereceleri ve stent yerleştirilme durumuna göre değerlen- dirildi. Bulgular: Her iki hastaneden 92 şer hasta çalışmaya alındı. Endoskopik üreteral taş tedavisi sonrası TÖTMde 85 ve ODHde 82 hastaya DJ stent yerleştirildi. Üniversite hastanesinde stent yerleştirilme sıklığı devlet hastanesin- de yüksek çıksa da istatiksel anlamlılık yoktu. Her iki grup arasında ortalama operasyon süreleri arasında istatiksel anlamlılık vardı. Sonuç: Endoskopik üreter taşı tedavisi sonrası DJ stent yerleştirilmesi çok sık uygulanmaktadır. Bizim çalışma- mıza göre üniversite hastanelerinde devlet hastanelerine göre daha sık DJ stent yerleştirilmesi yapılmaktadır. Bu- nun nedeni üniversite hastanelerinin son basamak mer- kezler olmasından dolayı daha komplike hastaların bu merkezlere refere edilmesi olabilir. Bu durumun daha net aydınlatılabilmesi için, prospektif, çok merkezli ve daha geniş serili çalışmalara ihtiyaç duyulmaktadır

Bir Üniversite ve Devlet Hastanesi Üreteroskopik Litotripsi Sonrası Stent Yerleştirilme Sıklığı

Objective: The aim of this study was to compare frequen- cy of ureteral stent placement after ureteroscopic litho- tripsy in a university and a state hospital of two different cities, which are endemic in terms of stone and often ure- terolithotripsy was performed for urolithiasis treatment. Methods: The patients who applied in to urology clinic of Inonu University Turgut Ozal Medical Center (TOMC) and urology clinic of Osmaniye State Hospital (OSH) between January 2014 and May 2014 were evaluated retrospec- tively. The patients who underwent ureteroscopic lithotrip- sy due to ureteral stone, were evaluated stone locations, stone sizes, grades of pelvicaliectasia and ureteral stent placement status. Results: About 92 patients were enrolled into the study from the both hospital. After the endoscopic ureteral stone treatment, Double J stent was placed in 85 patients in TOMC (92.3%) and 82 patients in OSH (89.1%). Stent im- plantation rate in the university hospital was higher than the state hospital but this was not statistically significant. There was a statistically meaningful difference in mean operative time between the 2 groups. Conclusion: Double J stent placament is recently per- formed too often after the endoscopic ureteral stone treat- ment. According to our study, university hospitals have a higher rate of incidence of double j stent placement ac- cording to state hospitals. It can be reason for that, uni- versity hospitals as the last line treatment centers, more complicated cases that refer to these centers. But in this matter, prospective, multicenter and larger series studies are needed

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1. Bagley DH. Indications of ureteropyeloscopy. In Huffman Bagley DHLyon ES.eds Ureteroscopy Philadelphia WB Saunders, 1988 b, PP51-72 2. Weimin Yu, Cheng F, Zhang X, et al. Retrograde uretero- scopic treatment for upper ureteral stones: A 5 Year Retro- spective study. J Endourol 2010;24:1753-1757. 3. Manan A, Anwar MS, Shah AA, et al. Efficacy of pneumatic lithoclast in the management of ureteric calculi. www.sims. edu.pk/esculapio.html:29-32. 4. Gerber GS, Stockton BR. Use of stents after ureteroscopic stone removal. J Endourol 2006;20:383-385. 5. Knoll T. Arbeitskreis Harnsteine der Akademie der Deutschen Urologen, Arbeitskreis Endourologie und Steinerkrankung der Osterreichischen Gesellschaft fuer Urologie. S2 guide- lines on diagnostic, therapy and metaphylaxis of urolithia- sis : part 1: diagnostic and therapy. Urologe A 2009;48:917- 924. 6. Preminger GM, Tiselius HG, Assimos DG, et al. Guideline for the management of ureteral calculi. J Urol 2007;178:2418- 2434. 7. Strope SA, Wolf JS Jr, Hollenbeck BK. Changes in gender distribution of urinary stone disease. Urology 2010;75:543- 546. 8. Efekli A, Tok A, Altunrende F, et al. Life style and nutritional habits in cases with urinary stone disease. Türk Üroloji Dergisi 2005;31:113-118. 9. Byrni RR, Auge BK, Kourambas J, et al. Routine Ureteral Stenting is Not Necessary after Ureteroscopy and Uretero- pyeloscopy: A Randomized Trial. J Endourol 2002;16:9-13. 10. Srivastava A, Gupta R, Kumar A et al. Routine Stenting after Ureteroscopy for Distal Ureteral Calculi Is Unneces- sary: Results of a Randomized Controlled Trial. J Endourol 2003;17:871-874. 11. Lingeman JE, Preminger GM, Berger Y, et al: Use of a temporary ureteral drainage stent after uncomplicated ure- teroscopy: Results from a Phase II Clinical Trial. J Urol 2003;169:1682-1688. 12. Chen YT, Chen J, Wong WY, et al. Is ureteral stent- ing necessary after uncomplicated ureteroscopic litho- tripsy? a prospective, randomized controlled trial. J Urol 2002;167:1977-1980. 13. Novac C, Pricop C, Costache C, et al. Ureteral stenting after retrograde ureteroscopy. Experience of Iasi urological de- partment. Rev Med Chir Soc Med Nat Iasi 2003;107:153- 156.