Editorials

Indwelling stents after ureteroscopy

BMJ 2007; 334 doi: http://dx.doi.org/10.1136/bmj.39149.561134.80 (Published 15 March 2007) Cite this as: BMJ 2007;334:544
  1. Colin H Wilson, specialist registrar,
  2. David A Rix, consultant in urological and renal transplant surgery (David.Rix@nuth.nhs.uk)
  1. The Freeman Hospital, Newcastle upon Tyne NE7 7DN

    Can cause significant postoperative morbidity and should be used with caution

    In this week's BMJ, Nabi and colleagues1 present a meta-analysis of randomised controlled trials of the insertion of indwelling stents after uncomplicated ureteroscopy. During the past quarter of a century the development and use of endoscopic equipment in urology has increased. Semirigid and flexible instruments have been developed with working channels to allow passage of biopsy forceps, baskets, and laser fibres. Stones in the ureter, and even within the pelvis and peripheral calyces of the kidney, can now be fragmented and extracted. Upper tract transitional cell carcinomas can be diagnosed and, where indicated, treated endoscopically.

    There remains controversy, however, about whether indwelling stents should be routinely inserted after these procedures. Balloon dilatation of the ureteric orifice, stone fragmentation and basket retrieval of fragments, biopsy, and destruction of mucosal lesions can all cause trauma …

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