Efficiency of Early Ureteric Stenting for Urosepsis Associated with Urinary Tract Lithiasis

Abstract

Introduction: Our objective was to evaluate the differences between the early or delayed placement of the ureteral stent in patients with urosepsis associated with urinary tract lithiasis.

Material and Methods: Retrospective review of patients admitted to our institution between 2011 and 2015 with the diagnosis of urosepsis associated with urinary tract calculi, having ureteral stent placement. Early and delayed stenting groups were defined by the median waiting for ureteral stent placement. The primary outcomes were length of hospital stay (LOS) and spontaneous stone passage (SSP) after stent placement. Statistical analysis included chi-square test, linear regression and Spearman correlation.

Results: A total of 42 patients (mean age: 58; 32 females) had a mean number of 3.38 days since emergency room admission to ureteral stenting. The median wait to ureter stenting was 2.5 days. The overall mean length of hospital stay was 12.2 days. The early stenting group had a significantly shorter LOS than the delayed stenting group (mean 5.6 vs 18.8 days; p<0.001). The early stenting group had predominantly lumbar calculi compared to the delayed stenting group (76.2% vs 42.8%; p=0.029). The early stenting group had improved SSP compared to the delayed group (61.9% vs 47.6%; p=0.268). If we consider the lumbar calculi only, there is a relation in SSP between early and delayed stenting groups (p=0.027).

Conclusion: There is a significant reduction of LOS in patients with urosepsis associated with urinary tract lithiasis when early ureteral stenting is performed. We observed a trend of improved stone passage in the early stenting group with significance in lumbar calculi between the two groups.