Minerva
BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7354.52 (Published 06 July 2002) Cite this as: BMJ 2002;325:52All rapid responses
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Dear Sir/Madam,
I read with interest your article in Minerva (BMJ 2002;325:52 (6th
July) regarding stenting post lithotripsy. Although accepting Minerva as a
refreshing and somewhat light-hearted purveyor of knowledge, I would like
to make two points.
Firstly, to clarify matters, the group looked at ureteric and not
urethral stents (as stated).
It is also worth mentioning that the method of lithotripsy was
ureteroscopic, and not extracorporeal shock wave lithotripsy (ESWL) as one
might otherwise assume.
Of interest, a following article (J.Urol 2002;167: 1981-1983) found
that double J stenting reduced hospital readmissions and emergency room
visits following ESWL in solitary kidney stones (10-20 mm) and proximal
ureter stones (<20 mm).
Yours faithfully,
John A. Bycroft MRCS
Clinical Research Fellow
Institute of Urology and Nephrology
Competing interests: No competing interests
Urethral stenting and lithotripsy
To correct an error, obviously included in the initial minerva
article to test the readership; Urologists would actually agree
universally that inserting stents into the urethra are not required
following lithotripsy! The debate about ureteric, as opposed to urethral,
stenting is more contentious. I would agree that the current urological
vogue is to limit the use of stents where possible. They can cause some
patients misery, but can also reduce complications in selected patients.
One group of patients that may benefit from ureteric stenting are patients
with large renal calculi (one definition may be stones>2.5cms) in whom
stents can reduce, but not abolish, the incidence of steinstrasse (a
difficult and potentially dangerous condition in which the ureter becomes
blocked by a column of stone fragments).
Competing interests: No competing interests