The regular use of calcium channel blockers before flexible URS appears to facilitate primary UAS insertion: a retrospective study in a single center.

PURPOSE: To evaluate the effect of regular use of CCB before flexible URS for successful primary UAS insertion. MATERIALS AND METHODS: We retrospectively analyzed 209 patients who underwent flexible ureteroscopy (URS) for upper urinary tract calculi between Jan 2021 and Dec 2021. Patients were divided into two groups based on whether calcium channel blockers (CCB) were used (n = 72) or not (n = 137). The following parameters were collected: age, sex, height and weight, BMI, stone location, stone burden, number of stones, operation time, hospital stay, hospital readmission, post-operative fever, post-operative SIRS rate, Clavien-Dindo grade, hospitalization costs, successful primary UAS insertion. We compared the two groups using Student's t test, Mann-Whitney U test and χ2 test for quantitative and categorical variables, respectively. A logistic regression model was used to identify predictive factors of UAS successful primary insertion. RESULTS: Compared with the non-CCB group, the CCB group had a higher successful primary UAS insertion rate (97.2% vs.85.4%, p = 0.008), and a lower hospital readmission rate (2.8% vs.12.4%, p = 0.021). In multivariate analyses, the regular use of CCB was the only predictive factor of successful primary UAS insertion rate (OR 6.32, 95% CI 1.41-28.29, p = 0.016). CONCLUSION: The regular use of calcium channel blockers (CCB) before flexible URS appears to facilitate ureteral access sheaths (UAS) primary insertion.

Comparison of pre-indwelling double-J stents versus ureteral catheters for artificial hydronephrosis in percutaneous nephrolithotomy: A retrospective cohort study.

PURPOSE: To compare the clinical efficacy and safety of pre-indwelling double-J stents versus ureteral catheters for artificial hydronephrosis in percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: We retrospectively analyzed the data of 1,258 patients who underwent PCNL for kidney stones from August 2017 to July 2020 in our hospital. Among them, 682 patients had double-J stents inserted (DJ group) and 576 patients had ureteral catheters (UC group). We analyzed baseline patient characteristics, perioperative outcomes, and complications in both groups. RESULTS: The puncture success rate was 97.9% and 97.4% in the DJ and UC groups, respectively (p>0.05). The operation time was 74.5±37.8 minutes in the DJ group compared with 80.8±38.5 minutes in the UC group (p=0.004). The total stone-free rate in the DJ and UC groups was 80.5% and 78.7%, respectively (p>0.05). The incidence of perioperative complications was relatively low in both groups and showed no obvious differences. In the subgroup analysis, the operation time for patients with no obvious or mild hydronephrosis preoperatively was significantly shorter in the DJ group than in the UC group (p<0.05). However, there were no significant differences among patients who had moderate or severe hydronephrosis preoperatively. CONCLUSIONS: It is feasible, safe, and effective to create artificial hydronephrosis by insertion of pre-indwelling double-J stents in PCNL surgery. Furthermore, the operation time was significantly shorter in the DJ group than in the group with pre-indwelling ureteral catheters, especially in patients who had no obvious or mild hydronephrosis preoperatively.