Urinary Stone Location with Ureteral Stents in Place: Always on the Move, and not Where you Would Expect
Vol. 17 No. 6 (2020),
9 January 2021
Purpose: To assess migration of urinary stones with ureteral stents in place.
Materials and Methods: We performed a retrospective analysis of stone characteristics and locations in patients treated with secondary retrograde intrarenal surgery for symptomatic urinary stones at our institution. We analyzed 393 patients with a median age of 53 years and a median stone size of 7 mm. Stone location was assessed at ureteral stent insertion and four weeks later prior to stent removal and retrograde intrarenal surgery (RIRS).
Results: Migration of urinary stones was seen in 33.1% of the patients with an indwelling ureteral stent. Stones with caudal migration were smaller for any given initial position. 7.1% of the stones were located at one of the three sites of narrowing at initial presentation, this percentage increased to 18.8% at the time of stone extraction. Stone composition did not affect stone migration.
Conclusion: Radiographic imaging prior to retrograde intrarenal surgery is recommended due to the migration of urinary stones with indwelling ureteral stents. The most appropriate surgical approach can be devised depending on stone localization.
- urinary stones
- stone migration
- ureteral stents
How to Cite
Wein AJ, Kavoussi LR, Partin AW, et al. Campbell-Walsh Urology, 11th Edition. Elsevier LTD, Oxford; 2017.
Baumgarten L, Desai A, Shipman S, et al. Spontaneous passage of ureteral stones in patients with indwelling ureteral stents. Can J Urol 2017;24:9024-9029.
Kuebker JM, Robles J, Kramer JJ, Miller NL, Herrell SD, Hsi RS. Predictors of spontaneous ureteral stone passage in the presence of an indwelling ureteral stent. Urolithiasis 2019;47:395-400.
Eisner BH, Reese A, Sheth S, Stoller ML. Ureteral stone location at emergency room presentation with colic. J Urol 2009;182:165-168.
Ordon M, Schuler TD, Ghiculete D, Pace KT, Honey RJ. Stones lodge at three sites of anatomic narrowing in the ureter: clinical fact or fiction? J Endourol 2013;27:270-276.
Stojkova Gafner E, Grüter T, Furrer MA, et al. A treatment strategy to help select patients who may not need secondary intervention to remove symptomatic ureteral stones after previous stenting. World J Urol 2020 doi: 10.1007/s00345-020-03087-1.
Lennon GM, Thornhill JA, Grainger R, McDermott TE, Butler MR. Double pigtail ureteric stent versus percutaneous nephrostomy: effects on stone transit and ureteric motility. Eur Urol 1997;31:24–29.
Khan SR, Pearle MS, Robertson WG, et al. Kidney stones. Nat. Rev. Dis. Primers, 2, 16008. https://doi.org/10.1038/nrdp.2016.8
Türk C, Neisius A, Petrik A, Seitz C, Skolarikos A, Knoll T. European Association of Urology. Non-Oncology Guidelines. Urolithiasis: http://uroweb.org/guideline/urolithiasis/. Accessed April 2020.
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