Stone Disease: Surgical Therapy VIIMP75-05 FAST TRACK STENT STUDY (FAST): SHORT TERM EXTERNAL URETER STENTING SHOWS SIGNIFICANT BENEFIT IN COMPARISON TO ROUTINE DJ STENT PLACEMENT AFTER URETERORENOSCOPIC STONE EXTRACTION – A PROSPECTIVE-RANDOMIZED TRAIL
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INTRODUCTION AND OBJECTIVES
Does short-term ureter stenting using an external ureter catheter (UC) for 6 hours following ureterorenoscopic stone extraction (URS) provide an equivalent outcome in comparison to postoperative double-J (DJ) ureter stenting?
METHODS
Between 08/2014 and 08/2015, 141 patients initially treated with a DJ insertion for 7 days were prospectively randomized to UC for 6 hours vs DJ insertion for 3-5 days after stone extraction via URS (incl. flexible URS) in a single academic center. Exclusion criteria were acute urinary tract infection, a solitary kidney or a stone mass more than 25mm. Study endpoints were ureter-stent related symptoms and pain assessed by a validated questionnaire (USSQ) and visual analogue scale (VAS) before
RESULTS
Endoscopic procedures performed by 9 surgeons resulted in more than 90% stone removal in all cases (n=141) in a mean operation time of 24 minutes (range 5-63 min). Groups did not differ in mean age (48 years), mean BMI (28.1) and stone size (5.4 mm). Patients, who received short-term UC, showed a significant higher quality of life (USSQ) compared to patients with a long-term DJ: In the UC group the urinary index score was significantly lower (16.8 vs. 27.8; p <0.0001) as well as the pain score
CONCLUSIONS
In patients who had a DJ prior to secondary ureteroscopic stone removal postoperative short-term ureteral stenting should be standard of care rather than routine DJ insertion.
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