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Impact of preoperative stenting on the outcome of flexible ureterorenoscopy for upper urinary tract urolithiasis: a systematic review and meta-analysis


Citation

Fahmy, Omar and S. H. S. M., Hadi and Lee, C. K. S. and Khairul Asri, Mohd Ghani (2021) Impact of preoperative stenting on the outcome of flexible ureterorenoscopy for upper urinary tract urolithiasis: a systematic review and meta-analysis. Urologia Internationalis, 106 (7). 679 - 687. ISSN 0042-1138; ESSN: 1423-0399

Abstract

Purpose: This study aimed to investigate the effect of preoperative stenting (POS) on the perioperative outcomes of flexible ureterorenoscopy (fURS). Materials and Methods: A systematic review and meta-analysis was conducted based on the PRISMA statement. From the initially retrieved 609 reports, we excluded the ineligible studies at 2 stages. We only included studies that contained fURS patients with and without POS in the same report. Data of patients who underwent semirigid ureteroscope only were excluded from the analysis. The Newcastle-Ottawa Scale (NOS) system was applied for risk of bias assessment. Results: A total of 20 studies including 5,852 patients were involved. 48.5% of the patients had preoperative stent. Stone-free rate was significantly higher with prestenting; odds ratio (OR) was 1.98 (95% CI: 1.51–2.58) (Z = 5.02; p = 0.00001). It also displayed tendency toward lower complications; OR was 0.74 (95% CI: 0.52–1.05) (Z = 1.67; p = 0.09). POS significantly increased the use of ureteral access sheath; OR was 1.49 (95% CI: 1.05–2.13) (Z = 2.22; p = 0.03). Risk of bias assessment showed 13 and 7 studies with low and moderate risk, respectively. Conclusions: POS clearly improves the stone-free rates after fURS. It might reduce the complications, especially ureteral injury. These findings might help solve the current debate and can be useful for urologists during patient counselling for a proper decision-making.


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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
DOI Number: https://doi.org/10.1159/000518160
Publisher: S. Karger AG
Keywords: Retrograde intrarenal surgery; Preoperative stenting; Prestenting; Flexible ureteroscopy; Ureterorenoscopy
Depositing User: Ms. Che Wa Zakaria
Date Deposited: 21 Sep 2023 03:49
Last Modified: 21 Sep 2023 03:49
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.1159/000518160
URI: http://psasir.upm.edu.my/id/eprint/101798
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