Introduction: Previous studies have shown that prestenting in ureterorenoscopic stone removal (URS) is carried out more frequently in Germany than in other countries. Objective: This investigation evaluated the impact of high prestenting rates on outcomes as well as the influence of stone characteristics and treatment habits on prestenting. Methods: The dataset from the BUSTER observational study was used. Patient and stone characteristics, as well as treatment outcomes, were analyzed for 307 cases from 14 urological clinics in Germany. Results: The overall prestenting rate was 70.0%. Prestenting rates were significantly higher for renal stones than ureteric stones (84.6 vs. 60.6%, p < 0.0001). Compared to the unstented cases, prestenting for renal stones improved stone-free rates (73.2 vs. 11.1%, p < 0.0001) and increased the rate of completely lesion-free URS (45.4 vs. 16.7%, p = 0.034) while reducing the rate of poststenting (from 100 to 80.8%, p = 0.041). None of these effects could be demonstrated when prestenting for ureteric stones. Prestenting rates were less variable for renal stones (57–100%) than for ureteric stones (0–100%, p < 0.01). Conclusions: This study confirms the benefits of prestenting in URS for renal stones but not for ureteric stones. There were considerable differences in prestenting rates between the participating clinics.

1.
Huffman
JL
,
Bagley
DH
,
Lyon
ES
.
Treatment of distal ureteral calculi using rigid ureteroscope
.
Urology
.
1982
Dec
;
20
(
6
):
574
7
.
[PubMed]
0090-4295
2.
Perera
M
,
Papa
N
,
Kinnear
N
,
Wetherell
D
,
Lawrentschuk
N
,
Webb
D
, et al
Urolithiasis Treatment in Australia: The Age of Ureteroscopic Intervention
.
J Endourol
.
2016
Nov
;
30
(
11
):
1194
9
.
[PubMed]
0892-7790
3.
Finney
RP
.
Experience with new double J ureteral catheter stent
.
J Urol
.
1978
Dec
;
120
(
6
):
678
81
.
[PubMed]
0022-5347
4.
Lumma
PP
,
Schneider
P
,
Strauss
A
,
Plothe
KD
,
Thelen
P
,
Ringert
RH
, et al
Impact of ureteral stenting prior to ureterorenoscopy on stone-free rates and complications
.
World J Urol
.
2013
Aug
;
31
(
4
):
855
9
.
[PubMed]
0724-4983
5.
Rubenstein
RA
,
Zhao
LC
,
Loeb
S
,
Shore
DM
,
Nadler
RB
.
Prestenting improves ureteroscopic stone-free rates
.
J Endourol
.
2007
Nov
;
21
(
11
):
1277
80
.
[PubMed]
0892-7790
6.
Pengfei
S
,
Yutao
L
,
Jie
Y
,
Wuran
W
,
Yi
D
,
Hao
Z
, et al
The results of ureteral stenting after ureteroscopic lithotripsy for ureteral calculi: a systematic review and meta-analysis
.
J Urol
.
2011
Nov
;
186
(
5
):
1904
9
.
[PubMed]
0022-5347
7.
Assimos
D
,
Crisci
A
,
Culkin
D
,
Xue
W
,
Roelofs
A
,
Duvdevani
M
, et al;
CROES URS Global Study Group
.
Preoperative JJ stent placement in ureteric and renal stone treatment: results from the Clinical Research Office of Endourological Society (CROES) ureteroscopy (URS) Global Study
.
BJU Int
.
2016
Apr
;
117
(
4
):
648
54
.
[PubMed]
1464-4096
8.
Lebentrau
S
,
May
M
,
Ziegler
H
,
Werthemann
P
,
Enzmann
T
,
Schostak
M
, et al
Die Empfehlungen der S2k-Leitlinie zur Diagnostik, Therapie und Metaphylaxe der Urolithiasis bilden einen sicheren Handlungskorridor für die ureterorenoskopische Steintherapie – Ergebnisse der BUSTER-Studie
.
Aktuelle Urol
.
2017
;
•••
:
[PubMed]
0001-7868
9.
Schoenthaler
M
,
Wilhelm
K
,
Kuehhas
FE
,
Farin
E
,
Bach
C
,
Buchholz
N
, et al
Postureteroscopic lesion scale: a new management modified organ injury scale—evaluation in 435 ureteroscopic patients
.
J Endourol
.
2012
Nov
;
26
(
11
):
1425
30
.
[PubMed]
0892-7790
10.
Dindo
D
,
Demartines
N
,
Clavien
PA
.
Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey
.
Ann Surg
.
2004
Aug
;
240
(
2
):
205
13
.
[PubMed]
0003-4932
11.
Cook
SJ
,
Niehaus
J
,
Zuhlke
S
.
A warning on separation in multinomial logistic models
.
Research & Politics.
2018
;
5
(
2
):
205316801876951
.
12.
Hubert
KC
,
Palmer
JS
.
Passive dilation by ureteral stenting before ureteroscopy: eliminating the need for active dilation
.
J Urol
.
2005
Sep
;
174
(
3
):
1079
80
.
[PubMed]
0022-5347
13.
Staubli
SE
,
Mordasini
L
,
Engeler
DS
,
Sauter
R
,
Schmid
HP
,
Abt
D
.
Economic Aspects of Morbidity Caused by Ureteral Stents
.
Urol Int
.
2016
;
97
(
1
):
91
7
.
[PubMed]
0042-1138
14.
Nevo
A
,
Mano
R
,
Baniel
J
,
Lifshitz
DA
.
Ureteric stent dwelling time: a risk factor for post-ureteroscopy sepsis
.
BJU Int
.
2017
Jul
;
120
(
1
):
117
22
.
[PubMed]
1464-4096
15.
Türk
C
,
Neisius
A
,
Petřík
A
,
Seitz
C
,
Thomas
K
,
Skolarikos
A
. EAU Guidelines on Urolithiasis 2018.
European Association of Urology Guidelines
. 2018 Edition.
Arnhem, The Netherlands
:
The European Association of Urology Guidelines Office
;
2018
.
16.
Assimos
D
,
Krambeck
A
,
Miller
NL
,
Monga
M
,
Murad
MH
,
Nelson
CP
, et al
Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART I
.
J Urol
.
2016
Oct
;
196
(
4
):
1153
60
.
[PubMed]
0022-5347
17.
Jessen
JP
,
Breda
A
,
Brehmer
M
,
Liatsikos
EN
,
Millan Rodriguez
F
,
Osther
PJ
, et al
International Collaboration in Endourology: Multicenter Evaluation of Prestenting for Ureterorenoscopy
.
J Endourol
.
2016
Mar
;
30
(
3
):
268
73
.
[PubMed]
0892-7790
18.
Shields
JM
,
Bird
VG
,
Graves
R
,
Gómez-Marín
O
.
Impact of preoperative ureteral stenting on outcome of ureteroscopic treatment for urinary lithiasis
.
J Urol
.
2009
Dec
;
182
(
6
):
2768
74
.
[PubMed]
0022-5347
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