A Novel Visual Grading for Ureteral Encrusted Stent Classification to Help Decide the Endourologic Treatment


Manzo B. O., Alarcon P., Lozada E., Ojeda J., Morales C., GÖKCE M. İ., ...Daha Fazla

JOURNAL OF ENDOUROLOGY, cilt.35, sa.9, ss.1314-1319, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 35 Sayı: 9
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1089/end.2020.1225
  • Dergi Adı: JOURNAL OF ENDOUROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.1314-1319
  • Anahtar Kelimeler: stent, renal stone, lithotripsy, encrusted, ureteral, grading, MANAGEMENT, FORGOTTEN
  • Ankara Üniversitesi Adresli: Evet

Özet

Objective: The aim of the study is to propose a visual classification for encrusted stents (ESs) to help choose the appropriate endourologic treatment. Materials and Methods: A multicenter, retrospective, and descriptive study was performed. A total of 140 patients with encrusted Double-J stents were enrolled from 5 different institutions. The novel visual grading for ureteral encrusted stent (V-GUES) classification system ranges from A to D, increasing with severity of encrustation. Results: ESs could be removed with a single intervention in 112 patients (86.8%). Type A and B ESs could be removed in all patients (100% success). Type D stents had minor retrieval and stone-free rates (p = 0.006 and p < 0.0001, respectively). Flexible ureteroscopy had a low success rate (77.7%) for type C stents (odds ratio [OR]: 0.21). Combined access had a 100% success rate for retrieval of type C ESs and a 92.9% success rate for type D ESs (OR: 9.18). Type D stents were associated with patients requiring more than one session to retrieve the stent (OR: 0.11) and stones (OR: 0.21). Conclusions: The V-GUES system is associated with treatment success rates of ES retrieval and stone-free status. It is also associated with the complication rate and the number of sessions needed for patients to be stent and stone free. The V-GUES classification could help counsel patients about the best treatment options and their outcomes. Further prospective studies will be needed to provide external validation.