Abstract:
INTRODUCTION:Prestenting of the ureter is commonly performed to allow for passive dilation and better access to the urinary system during subsequent procedures. There is no level 1 evidence on the duration of prestenting and EAU guidelines suggest a 1-2 weeks duration. MATERIALS AND METHODS:Our primary aim is to investigate the optimal duration required for prestenting in a porcine model. Our secondary aim is to compare the ureteral wall compliance between the stented and the unstented ureters. METHODS:Three female pigs between 40 and 50 kg were used. We modified a human protocol for performing intravenous pyelograms in our study to obtain ureteral measurements on days 0, 5, 7, and 14. Unilateral stenting on days 0, 5, and 7 was performed. On day 14, bilateral nephroureterectomy was performed, and ureteral compliance was measured in the stent and unstented ureter. RESULTS:There were significant ureteral dilation between days 0 and 5 for all three pigs (p1 = 0.001, p2 ≤ 0.001 and p3 = 0.01). The rate of dilation appears to plateau after day 5 (p1 = 0.416, p2 = 0.344, and p3 = 0.774). Ureteral compliance in the stented ureter is better than in a nonstent ureter (p1 = 1.44 vs 0.13, p2 = 0.8 vs 0.04, p3 = 0.62 vs 0.2). An unexpected observation was the ureteral dilation and increased tortuosity in the unstented ureter in two of the three pigs (p1 = 0.152, p2 = 0.007). CONCLUSION:Our results suggest that optimal prestenting may be achieved in 5 days in a porcine model. It can potentially form the basis to start randomized human trials.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Lim KS,Lim YW,Yong DZP,Hao Y,Ho HSS,Ng LG,Sim ASPdoi
10.1089/end.2018.0872subject
Has Abstractpub_date
2019-04-01 00:00:00pages
325-330issue
4eissn
0892-7790issn
1557-900Xjournal_volume
33pub_type
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