Ureterorenoscopy And Lithotripsy with and Without DJ Insertion; Experience at Allied Hospital, Faisalabad

Abstract

Objective: To evaluate the success and safety of URS and lithotripsy with and without DJ stenting. Settings: Department of Urology and Kidney Transplantation, Faisalabad Medical University / Allied Hospital, Faisalabad-Pakistan. Duration: From January 2015 to August 2018. Methodology: It was prospective study. Total 210 were included in the study. 190 patients completed their follow up. URS and lithotripsy was done with pneumatic lithoclast. DJ stenting was done in 92 patients and 98 patients were left without DJ insertion. Results: All patients were divided into two groups. Group A comprised of 105 cases and Group B comprised of 105 patients. URS and lithotripsy were done successfully in 98 cases in group A and 92 cases in group B. Group A was without DJ insertion and Group B was with DJ insertion. Data was analyzed by chi-square test and p-value was calculated. Lower urinary tract symptoms, pain, Hematuria, stone passage, AUR and fever were noted in both groups. Lower urinary tract symptoms including dysuria was seen in 20(20.40%) in non-stented patients and 31(33.36%) in stented patients. Hematuria was seen in 3(3.06%) in non-stented patients and 4(4.34%) in stented patients. Fever was noted in 3(3.06%) in non-stented patients and 7(7.60%) in stented patients’ Acute urinary retention which needs catherization was found in 1(1.02%) in non-stented group and 2(2.17%) in stented group. Flank pain was seen in 22(22.44%) in non-stented patients and 18(19.56%) in group B. Five (5.10%) were unable to pass stone in group A and 2(2.17%) were unable to pass stone in group B. All these patients required repeat ureterorenoscopy and lithotripsy. There was no case of forgotten DJ or broken DJ in any group. Conclusion: URS and lithotripsy are procedure of choice for ureteric calculi. It can be performed safely and successfully without DJ insertion in most of the cases.